Significance of anaemia in patients with advanced heart failure receiving long-term mechanical circulatory support

Eur J Heart Fail. 2009 Oct;11(10):1000-4. doi: 10.1093/eurjhf/hfp110.

Abstract

Aims: The aim of this study was to analyse the prognostic impact of anaemia in patients receiving long-term left ventricular assist device (LVAD) support.

Methods and results: We reviewed the data of 65 consecutive patients who underwent LVAD support for at least 6 months. Anaemia was defined as haemoglobin levels <12.0 g/dL. Follow-up was performed 15 months after implantation. Anaemia was present in 30/65 patients (46%) after 6 months of LVAD support. Anaemic patients had higher levels of pre-implant creatinine (1.8 +/- 0.8 vs. 1.4 +/- 0.5 mg/dL; P = 0.04). The presence of anaemia after 6 months correlated with higher levels of creatinine and blood urea nitrogen and lower levels of albumin. Multivariate Cox proportional hazards regression analysis revealed that levels of haemoglobin <12 g/dL [risk ratio (RR), 8.94; 95% confidence interval (CI), 1.09-73.01; P = 0.04], creatinine >1.4 mg/dL (RR, 5.39; 95% CI, 1.78-16.30; P = 0.003), and albumin <1.5 g/L (RR, 3.23; 95% CI, 1.10-9.51; P = 0.03) were associated with all-cause mortality at 15 months. Long-term survival evaluated by Kaplan-Meier analysis was two times higher in non-anaemic patients after 6 months of LVAD support than in anaemic patients (P = 0.01).

Conclusion: Anaemia is related to adverse outcomes in patients receiving prolonged LVAD support.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Analysis of Variance
  • Anemia / diagnosis
  • Anemia / etiology*
  • Anemia / mortality
  • Blood Chemical Analysis
  • Cohort Studies
  • Erythropoietin / blood*
  • Female
  • Follow-Up Studies
  • Heart Failure / diagnosis
  • Heart Failure / mortality
  • Heart Failure / surgery*
  • Heart-Assist Devices / adverse effects*
  • Humans
  • Incidence
  • Long-Term Care
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Probability
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Sex Factors
  • Survival Analysis
  • Time Factors

Substances

  • Erythropoietin