The prognostic value of anemia in patients with diastolic heart failure

Tex Heart Inst J. 2009;36(3):220-5.

Abstract

Anemia is prevalent in heart-failure patients, and it has been associated with increased mortality rates. In a retrospective study, we evaluated the effects of anemia on long-term survival in patients who experienced purely diastolic heart failure.Heart-failure patients with preserved systolic function (left ventricular ejection fraction, > or =0.50) were evaluated retrospectively. Of 294 patients, 162 had anemia (group 1) and 132 had no anemia (group 2) upon baseline examination. Anemia was defined as a hemoglobin level below 12 g/dL in women and below 13 g/dL in men. Multivariate Cox proportional hazards regression was conducted in order to test whether hemoglobin levels were an independent predictor of 5-year hospitalization and mortality rates in patients with diastolic heart failure. A P value less than 0.05 was considered statistically significant.Group 1 patients had a shorter mean survival time (37.8 +/- 1.8 vs 44.9 +/- 1.8 mo, P = 0.01); however, there was no significant difference between the groups in hospitalization rate (7.2 +/- 7.1 vs 7.5 +/- 6.3, P = 0.677). In a subgroup analysis, anemia was a significant predictor of higher mortality rates in elderly patients (age, >75 yr) who had diastolic heart failure (P = 0.018).We found that anemia is associated with increased long-term mortality rates in patients who have diastolic heart failure. In addition, anemia appears to be an independent predictor of worse outcomes in elderly heart-failure patients.

Keywords: Age factors; anemia/blood/complications/epidemiology/mortality; diastole; heart failure/blood/complications/mortality/physiopathology; hemoglobins/analysis; patient readmission; prevalence; risk assessment; survival analysis; ventricular function/left.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anemia / blood
  • Anemia / etiology*
  • Anemia / mortality
  • Female
  • Heart Failure, Diastolic / complications*
  • Heart Failure, Diastolic / mortality
  • Heart Failure, Diastolic / physiopathology
  • Hemoglobins / metabolism
  • Hospitalization
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Stroke Volume
  • Time Factors
  • Ventricular Function, Left

Substances

  • Hemoglobins