Document Detail


Anemia in adults with congenital heart disease relates to adverse outcome.
MedLine Citation:
PMID:  19926019     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To assess the relation of anemia in noncyanotic adults with congenital heart disease (ACHD) to functional capacity and mortality. BACKGROUND: Anemia is common in acquired heart failure and affects prognosis. The presence of anemia and its relation to outcome in ACHD remain unknown. METHODS: Data were collected on consecutive noncyanotic ACHD patients attending our tertiary center between 2001 and 2006 in whom hemoglobin concentration was measured. Anemia was defined as hemoglobin concentration <13 g/dl in males and <12 g/dl in females. Cyanotic patients were excluded to avoid confounding from secondary erythrocytosis. RESULTS: Overall, 830 noncyanotic ACHD patients (age 36.5 +/- 15.0 years, 49.6% male) fulfilled the inclusion criteria. The prevalence of anemia was 13.1% and was highest in patients with congenitally corrected transposition of great arteries and Ebstein anomaly of the tricuspid valve. Anemic patients were more likely to be receiving diuretics (p < 0.0001) and have a lower mean corpuscular volume (p = 0.0001), with a trend toward a higher New York Heart Association functional class (p = 0.06). During a median follow-up of 47 months, 55 patients died. Anemic patients had a 3-fold higher mortality risk compared with nonanemic patients, even after propensity score adjustment for clinical variables such as systemic ventricular function, renal impairment, and diuretic therapy (adjusted hazard ratio: 3.00; 95% confidence interval: 1.46 to 6.13). CONCLUSIONS: Anemia is not uncommon in ACHD patients attending tertiary services and is associated with a 3-fold increased risk of death. Screening for anemia should be part of the routine assessment of ACHD patients for risk stratification and treatment when correctable causes are identified.
Authors:
Konstantinos Dimopoulos; Gerhard-Paul Diller; Georgios Giannakoulas; Ricardo Petraco; Aikaterini Chamaidi; Evaggelia Karaoli; Michael Mullen; Lorna Swan; Massimo F Piepoli; Philip A Poole-Wilson; Darrel P Francis; Michael A Gatzoulis
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  54     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-20     Completed Date:  2009-12-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2093-100     Citation Subset:  AIM; IM    
Affiliation:
Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, London, United Kingdom. k.dimopoulos02@ic.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anemia / epidemiology*
Ebstein Anomaly / surgery
Female
Heart Defects, Congenital / epidemiology*,  mortality
Hemoglobins / analysis
Humans
Male
Multivariate Analysis
Prognosis
Risk Assessment
Transposition of Great Vessels / surgery
Young Adult
Grant Support
ID/Acronym/Agency:
//British Heart Foundation
Chemical
Reg. No./Substance:
0/Hemoglobins

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