| Anemia in adults with congenital heart disease relates to adverse outcome. | |
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MedLine Citation:
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PMID: 19926019 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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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:
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Created Date: 2009-11-20 Completed Date: 2009-12-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 2093-100 Citation Subset: AIM; IM |
Affiliation:
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Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, London, United Kingdom. k.dimopoulos02@ic.ac.uk |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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//British Heart Foundation |
| Chemical | |
Reg. No./Substance:
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0/Hemoglobins |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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