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The product of eGFR and hemoglobin may help predict mortality in systolic heart failure patients without severe anemia and renal failure.
MedLine Citation:
PMID:  22395368     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVES: Cardiorenal anemia syndrome is defined in patients with heart failure (HF). Although individual influences of renal impairment and anemia were shown previously, complex interaction between the kidney, bone marrow, and the heart renders decision making relatively inefficient in patients with milder forms of these diseases. We aimed to investigate whether product of estimated glomerular filtration rate (eGFR) and hemoglobin (Hb) predicts outcomes in patients with HF.
STUDY DESIGN: The study included 148 consecutive patients (89 males, 59 females; mean age 68±10 years) who were hospitalized with acutely decompensated systolic HF and discharged alive. Discharge Hb levels were measured. Renal function was estimated via the MDRD (Modification of Diet in Renal Disease) formula. The eGFRxHb product was derived, and cut-off was defined using the ROC (receiver operating characteristic) analysis. The influence of eGFRxHb product on mortality was analyzed after a follow-up period of up to 34 months (mean 8.2±5.5 months).
RESULTS: The mean Hb was 12.7±2 g/dl, the mean creatinine was 105±46 µmol/l, and the mean eGFR was 61±23 ml/min/1.73 m². Eighty-two patients (55.4%) had an eGFR of <60 ml/kg/m². During the follow-up, 27 patients died. Optimal cut-off level of eGFRxHb product to predict mortality was found to be ≤788 with a sensitivity of 82.6% and specificity of 51.3%. In multivariate Cox proportional analysis, only eGFRxHb product ≤788 (HR 4.488, 95% CI 1.500-13.433, p=0.007) and presence of atrial fibrillation (HR 2.644, 95% CI 1.113-6.280, p=0.028) were independent predictors of mortality in patients with HF.
CONCLUSION: We concluded that the product of eGFR and Hb might be useful in prediction of mortality among patients with systolic HF.
Mehmet Birhan Yılmaz; Ali Zorlu; Gökhan Bektaşoğlu; Osman Can Yontar; Izzet Tandoğan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Türk Kardiyoloji Derneği arşivi : Türk Kardiyoloji Derneğinin yayın organıdır     Volume:  40     ISSN:  1016-5169     ISO Abbreviation:  Turk Kardiyol Dern Ars     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-03-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9426239     Medline TA:  Turk Kardiyol Dern Ars     Country:  Turkey    
Other Details:
Languages:  eng     Pagination:  9-15     Citation Subset:  IM    
Department of Cardiology, Medicine Faculty of Cumhuriyet University, Sivas, Turkey.
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