Consuegra-Sánchez L, Núñez J, Fácila L, Bertomeu V, Robles R, Llácer Á

Language: Spanish
References: 22
Page: 279-284
PDF size: 75.50 Kb.

ABSTRACT

Background and aim. Studies performed on selected patients in other countries have shown that anemia is frequently associated with heart failure and results in a worse prognosis. We sought to determine the prognosis significance of hemoglobin/anemia in patients with acute heart failure which required management with hospital admission. Material and Methods. We analysed 412 patients diagnosed with acute heart failure as outlined in the criteria of the European Society of Cardiology (ESC). We measured hemoglobin within the first 24 hours and obtained demographic, clinical and biochemical variables. Anemia was defined in accordance with OMS criteria. The main variable was all-cause mortality. The association between all-cause mortality and hemoglobin/anemia was determined using the multiple regression Cox model. Results. During follow-up (median six months) we observed 101 all-cause mortality events. In the multivariate analysis, hemoglobin was an independent predictive variable adjusted by covariates (HR 1.15, IC 95% [1.04-1.25], p = 0.014). Anemia (hemoglobin ‹ 13 g/dL) was also found to be an independent predictive variable adjusted by covariates (HR 2.06, IC al 95% [1.28- 3.33], p = 0.003). Conclusions. Hemoglobin and anemia (hemoglobin ‹ 13 g/dL) are consistently associated with shortterm, poorer survival in patients with acute heart failure.

REFERENCES

1. Komajda M. Prevalence of anemia in patients with chronic heart failure and their clinical characteristics. J Card Fail 2004; 10: S1-S4.

2. Lupon J, Urrutia A, Gonzalez B, Herreros J, Altimir S, Coll R, et al. Prognostic significance of hemoglobin levels in patients with heart failure. Rev Esp Cardiol 2005; 58(1): 48-53.

3. Silverberg DS, Wexler D, Iaina A. The importance of anemia and its correction in the management of severe congestive heart failure. Eur J Heart Fail 2002; 4(6): 681-6. Review.

4. Nieminen MS, Bohm M, Cowie MR, Drexler H, Filippatos GS, Jondeau G. Executive summary of the guidelines on the diagnosis and treatment of acute heart failure: the Task Force on Acute Heart Failure of the European Society of Cardiology. Eur Heart J 2005; 26(4): 384-416. Epub 2005 Jan 28.

5. Tanner H, Moschovitis G, Kuster GM, Hullin R, Pfiiffner D, Hess OM, et al. The prevalence of anemia in chronic heart failure. Int J Cardiol 2002; 86(1): 115-21.

6. Tang WHW, Miller H, Partin M, et al. Anemia in heart failure: a single- center experience. J Am Coll Cardiol 2003; 41: 157A.

7. Hussein SJ, Jain R, Shlipak MG, et al. Chronic heart failure is not and independent cause of anemia. J Card Fail 2003; 9: 564.

8. Lindenfeld J. Prevalence of anemia and effects on mortality in patients with heart failure. Am Heart J 2005; 149(3): 391-401. Review.

9. Horwich TB, Fonarow GC, Hamilton MA, MacLellan WR, Borenstein J. Anemia is associated with worse symptoms, greater impairment in functional capacity and a significant increase in mortality in patients with advanced heart failure. J Am Coll Cardiol 2002; 39(11): 1780-6.

10. Bolger AP, Wolfram D, Sharma R, et al. Anemia in chronicheart failure: the relationship to inflammatory cytokine expression and prognostic importance. Circulation 2002; 106: S2-S570.

11. Felker GM, Gattis WA, Leimberger JD, Adams KF, Cuffe MS, Gheorghiade M, et al. Usefulness of anemia as a predictor of death and rehospitalization in patients with decompensated heart failure. Am J Cardiol 2003; 92(5): 625-8.

12. Anand I, McMurray JJ, Whitmore J, Warren M, Pham A, Mc-Camish MA, et al. Anemia and its relationship to clinical outcome in heart failure. Circulation 2004; 110(2): 149-54. Epub 2004 Jun 21.

13. Silverberg DS, Wexler D, Blum M, Iaina A, Sheps D, Keren G, et al. Effects of treatment with epoetin Beta on outcomes in patients with anaemia and chronic heart failure. Kidney Blood Press Res 2005; 28(1): 41-7. Epub 2004 Oct 15.

14. Grigorian-Shamagian L, Varela-Román A, Mazón-Ramos P, Pedreira-Pérez M, Rigueiro-Veloso P, Gonzalez-Juanatey JR. Anemia como nuevo predictor de la mortalidad de pacientes hospitalizados por insuficiencia cardiaca congestiva. Med Clin (Barc) 2005; 125(17): 647-52.

15. Sharma R, Francis DP, Pitt B, Poole-Wilson PA, Coats AJ, Anker SD. Haemoglobin predicts survival in patients with chronic heart failure: a substudy of the ELITE II trial. Eur Heart J 2004; 25(12): 1021-8.

16. Szachniewicz J, Petruk-Kowalczyk J, Majda J, Kaczmarek A, Reczuch K, Kalra PR, et al. Anaemia is an independent predictor of poor outcome in patients with chronic heart failure. Int J Cardiol 2003; 90(2-3): 303-8.

17. Wisniacki N, Aimson P, Lyle M. Is anemia a cause of heart failure in the elderly? Heart 2001; 85(Suppl): P4.

18. Tanner H, Moschovitis G, Kuster GM, Hullin R, Pfiiffner D, Hess OM, et al. The prevalence of anemia in chronic heart failure. Int J Cardiol 2002; 86(1): 115-21.

19. Silverberg DS, Wexler D, Blum M, et al. The use of subcutaneous erythropoietin and intravenous iron for the treatment of the anemia of severe, resistant congestive heart failure improves cardiac and renal function and functional cardiac class, and markedly reduces hospitalizations. J Am Coll Cardiol 2000; 35(7): 1737-44.

20. Androne AS, Katz SD, Lund L, LaManca J, Hudaihed A, Hryniewicz K, et al. Hemodilution is common in patients with advanced heart failure. Circulation 2003; 107(2): 226-9.

21. Sharma R, Francis DP, Pitt B, et al. Haemoglobin predicts survival in patients with chronic heart failure: a substudy of the ELITE II trial. Eur Heart J 2004; 25(12): 1021-8.

22. Cleland JG, Swedberg K, Follath F, et al. The EuroHeart Failure Survey programme —a survey on the quality of care among patients with heart failure in Europe. Part 2: treatment. Eur Heart J 2003; 24(5): 464-74.