Heart FailureOutcomes of Patients With Anemia and Acute Decompensated Heart Failure With Preserved Versus Reduced Ejection Fraction (from the ARIC Study Community Surveillance)
Section snippets
Methods
Since 2005, the ARIC study has conducted population-based retrospective surveillance of hospitalized events in Forsyth County, North Carolina; Washington County, Maryland; Jackson, Mississippi; and 8 northwest suburbs of Minneapolis, Minnesota. Surveillance eligibility is restricted to residents ≥55 years, with a hospitalization spanning at least 1 day and, for the purposes of our analysis, a discharge date between January 1, 2005, and December 31, 2010. Hospitalizations with any discharge
Results
All results are weighted to account for the sampling design, unless otherwise indicated. Of 15,461 hospitalizations with verified ADHF, 6,414 (41%) were classified as HFpEF and 9,047 (59%) as HFrEF. The mean age at discharge was 76 years; approximately half (52%) were women, and nearly 1/3 (29%) were black. The overall anemia prevalence was 70% and did not differ by HF type (p = 0.4). In unadjusted analyses, hemoglobin was positively correlated with glomerular filtration rate (r = 0.21; p
Discussion
In this population-based sample of patients hospitalized with ADHF, anemia was associated with both greater mortality risk and longer hospital stays. We observed significantly stronger associations in patients with HFpEF, which remained robust when examining hemoglobin as a continuous measure.
Many studies have established anemia as risk factor for death in HF patients; however, comparisons of risk by HF type have been inconsistent for hospitalized ADHF. In a study from the National Heart Care
Acknowledgment
The authors thank the staff and participants of the ARIC study for their important contributions.
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2023, Journal of the Society for Cardiovascular Angiography and InterventionsTrends in Hospital Admissions for Systolic and Diastolic Heart Failure in the United States Between 2004 and 2017
2022, American Journal of CardiologyCitation Excerpt :We also found a decrease in LOS between 2004 and 2011 and inpatient mortality between 2004 and 2008 for both systolic and diastolic HF admissions, consistent with recent reports.5 This may be a testament to the gradual improvement in our understanding of HF management and greater penetration of goal-directed medical therapy.1,14 A retrospective analysis is needed to determine which settings (rural vs suburban vs urban hospitals vs private clinics vs hospital-based clinics) see the least implementation so that resources can be focused accordingly toward training health care professions on improving HF care.
Anemia and Management of Heart Failure Patients
2021, Heart Failure ClinicsCitation Excerpt :The analysis from the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) dataset revealed that patients with HF with reduced EF (HFrEF) and anemia had the worst prognosis, whereas patients with HF with preserved EF (HFpEF) and anemia had a similar prognosis to those with HFrEF without anemia.38 On the other hand, when analyzing the population with acute decompensated HF from the Atherosclerosis Risk in Communities (ARIC) study, the authors concluded that the incremental risk of death and longer hospitalization associated with anemia was higher in patients with HFpEF (defined by an EF of ≥40%) than in those with HFrEF (EF of <40%).41 A more recent study, assessing the prognostic role of anemia in patients with HF classified according to the most recent classification proposed by the European Guidelines for the diagnosis and treatment of acute and chronic HF, showed no differences in risk across the left ventricular EF spectrum for all-cause mortality.
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2020, Transfusion and Apheresis ScienceCitation Excerpt :In hospitalized patients the reported prevalence of anemia is approximatively 25−50 % percent, depending on comorbidities and demographic factors (e.g. age and gender), and increases within the processes of care (e.g. procedural blood loss and phlebotomies) [1]. Moreover, anemia has been recognized as an independent risk factor for adverse outcome including higher risk of hospitalization or readmission, prolonged length of stay in hospital, as well as morbidity and mortality [2,3]. However, moderate anemia is often ignored in the preoperative phase and inappropriately overtreated with red blood cells (RBC) transfusion during and after surgery.
Predictors of In-Hospital Mortality after Transcatheter Aortic Valve Implantation
2020, American Journal of CardiologyCitation Excerpt :Liver fibrosis has been associated with higher all-cause mortality in HFpEF patients without AS, possibly due to activation of the renin-angiotensin-aldosterone system, fibrogenesis, and increased collagen turnover.27 In previous studies anemia has been associated with greater mortality in HFpEF patients compared with HFrEF without AS.28 In the OPTIMIZE-HF registry of 5,117 HF patients, Young et al found a significant interaction between HF type and hemoglobin level.29
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