Document Detail

Anemia and its relationship to clinical outcome in heart failure.
MedLine Citation:
PMID:  15210591     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Anemia is often observed in patients with chronic heart failure (CHF), but its implications for patient outcomes are not well understood. The goal of this study was to investigate the relationship between anemia, severity of CHF, and clinical outcomes. METHODS AND RESULTS: Hemoglobin concentration (Hb) was measured in 912 subjects with CHF enrolled in the Randomized Etanercept North American Strategy to Study Antagonism of Cytokines (RENAISSANCE) trial. In a subgroup of 69 subjects, cardiac MRI was performed at randomization and 24 weeks later. Anemia (Hb < or =12.0 g/dL) was present in 12% of subjects. Cox regression analysis indicated that for every 1-g/dL-higher baseline Hb, the risk of mortality was 15.8% lower (P=0.0009) and the risk of mortality or hospitalization for heart failure was 14.2% lower (P<0.0001). Greater CHF severity was associated with significantly lower Hb concentrations. An increase in Hb over time was associated with a decrease in left ventricular mass and lower mortality, whereas a decrease in Hb over time was associated with an increase in left ventricular mass and higher mortality. In multivariate analysis, anemia remained a significant, independent predictor of death or hospitalization for heart failure, with both outcomes being significantly higher in all NYHA classes. CONCLUSIONS: Anemia is frequently present in patients with CHF. Lower Hb is associated with greater disease severity, a greater left ventricular mass index, and higher hospitalization and mortality rates.
Inder Anand; John J V McMurray; James Whitmore; Marshelle Warren; Anh Pham; Mark A McCamish; Paul B J Burton
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2004-06-21
Journal Detail:
Title:  Circulation     Volume:  110     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-07-13     Completed Date:  2005-01-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  149-54     Citation Subset:  AIM; IM    
VA Medical Center, Minneapolis, Minn, USA.
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MeSH Terms
Anemia / complications*
Follow-Up Studies
Heart Failure / blood*,  drug therapy,  mortality,  pathology,  ultrasonography
Heart Ventricles / pathology
Hemoglobins / analysis
Hospitalization / statistics & numerical data
Hypertrophy, Left Ventricular / blood,  etiology,  pathology,  ultrasonography
Immunoglobulin G / therapeutic use
Life Tables
Magnetic Resonance Imaging
Middle Aged
Organ Size
Proportional Hazards Models
Randomized Controlled Trials as Topic
Receptors, Tumor Necrosis Factor / therapeutic use
Retrospective Studies
Severity of Illness Index
Treatment Outcome
Reg. No./Substance:
0/Hemoglobins; 0/Immunoglobulin G; 0/Receptors, Tumor Necrosis Factor; 185243-69-0/TNFR-Fc fusion protein

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