Evaluation and Long-Term Prognosis of New-Onset, Transient, and Persistent Anemia in Ambulatory Patients With Chronic Heart Failure
Evaluation and Long-Term Prognosis of New-Onset, Transient, and Persistent Anemia in Ambulatory Patients With Chronic Heart Failure W. H. Wilson Tang, Wilson Tong, Anil Jain, Gary S. Francis, C. Martin Harris, James B. Young We reviewed records of 6,159 consecutive ambulatory patients with chronic h...
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| Published in: | Journal of the American College of Cardiology Vol. 51; no. 5; pp. 569 - 576 |
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| Abstract | Evaluation and Long-Term Prognosis of New-Onset, Transient, and Persistent Anemia in Ambulatory Patients With Chronic Heart Failure W. H. Wilson Tang, Wilson Tong, Anil Jain, Gary S. Francis, C. Martin Harris, James B. Young We reviewed records of 6,159 consecutive ambulatory patients with chronic heart failure followed up at a single center between 2001 and 2006, and found the prevalence of anemia (hemoglobin <12 g/dl for men, <11 g/dl for women) to be 17.2%. At 6-month follow-up, new-onset anemia developed in 16% of patients without prior anemia, whereas 43% patients with anemia at baseline had resolution of their hemoglobin levels. Higher total mortality rates were evident in patients with persistent anemia (58% vs. 31%, p < 0.0001) or with incident anemia (45% vs. 31%, p < 0.0001) compared with those with without anemia at 6 months. |
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| AbstractList | Evaluation and Long-Term Prognosis of New-Onset, Transient, and Persistent Anemia in Ambulatory Patients With Chronic Heart Failure
W. H. Wilson Tang, Wilson Tong, Anil Jain, Gary S. Francis, C. Martin Harris, James B. Young
We reviewed records of 6,159 consecutive ambulatory patients with chronic heart failure followed up at a single center between 2001 and 2006, and found the prevalence of anemia (hemoglobin <12 g/dl for men, <11 g/dl for women) to be 17.2%. At 6-month follow-up, new-onset anemia developed in 16% of patients without prior anemia, whereas 43% patients with anemia at baseline had resolution of their hemoglobin levels. Higher total mortality rates were evident in patients with persistent anemia (58% vs. 31%, p < 0.0001) or with incident anemia (45% vs. 31%, p < 0.0001) compared with those with without anemia at 6 months.
This study sought to determine the characteristics and long-term prognosis of anemia in ambulatory patients with chronic heart failure.
Anemia is prevalent in heart failure, and may portend poor outcomes.
We reviewed 6,159 consecutive outpatients with chronic stable heart failure at baseline, short-term (3-month) follow-up, and long-term (6-month) follow-up between 2001 and 2006. Clinical, demographic, laboratory, and echocardiographic data were reviewed from electronic medical records. Mortality rates were determined from 6-month follow-up to end of study period.
Prevalence of anemia (hemoglobin [Hb] <12 g/dl for men, <11 g/dl for women) was 17.2% in our cohort. Diabetes, B-natriuretic peptide, left ventricular ejection fraction, and estimated glomerular filtration rate were independent predictors of baseline anemia. Documented evaluation of anemia was found in only 3% of all anemic patients, and better in internal medicine than in cardiology clinics. At 6-month follow-up, new-onset anemia developed in 16% of patients without prior anemia, whereas 43% patients with anemia at baseline had resolution of their hemoglobin levels. Higher total mortality rates were evident in patients with persistent anemia (58% vs. 31%, p < 0.0001) or with incident anemia (45% vs. 31%, p < 0.0001) compared with those with without anemia at 6 months.
These observations in a broad unselected outpatient cohort suggest that anemia in patients with heart failure is under-recognized and underevaluated. However, resolution of anemia was evident in up to 43% of patients who presented initially with anemia, and did not pose greater long-term risk for all-cause mortality. However, the presence of persistent anemia conferred poorest survival in patients with heart failure when compared with that of incident, resolved, or no anemia. OBJECTIVESThis study sought to determine the characteristics and long-term prognosis of anemia in ambulatory patients with chronic heart failure.BACKGROUNDAnemia is prevalent in heart failure, and may portend poor outcomes.METHODSWe reviewed 6,159 consecutive outpatients with chronic stable heart failure at baseline, short-term (3-month) follow-up, and long-term (6-month) follow-up between 2001 and 2006. Clinical, demographic, laboratory, and echocardiographic data were reviewed from electronic medical records. Mortality rates were determined from 6-month follow-up to end of study period.RESULTSPrevalence of anemia (hemoglobin [Hb] <12 g/dl for men, <11 g/dl for women) was 17.2% in our cohort. Diabetes, B-natriuretic peptide, left ventricular ejection fraction, and estimated glomerular filtration rate were independent predictors of baseline anemia. Documented evaluation of anemia was found in only 3% of all anemic patients, and better in internal medicine than in cardiology clinics. At 6-month follow-up, new-onset anemia developed in 16% of patients without prior anemia, whereas 43% patients with anemia at baseline had resolution of their hemoglobin levels. Higher total mortality rates were evident in patients with persistent anemia (58% vs. 31%, p < 0.0001) or with incident anemia (45% vs. 31%, p < 0.0001) compared with those with without anemia at 6 months.CONCLUSIONSThese observations in a broad unselected outpatient cohort suggest that anemia in patients with heart failure is under-recognized and underevaluated. However, resolution of anemia was evident in up to 43% of patients who presented initially with anemia, and did not pose greater long-term risk for all-cause mortality. However, the presence of persistent anemia conferred poorest survival in patients with heart failure when compared with that of incident, resolved, or no anemia. Evaluation and Long-Term Prognosis of New-Onset, Transient, and Persistent Anemia in Ambulatory Patients With Chronic Heart Failure W. H. Wilson Tang, Wilson Tong, Anil Jain, Gary S. Francis, C. Martin Harris, James B. Young We reviewed records of 6,159 consecutive ambulatory patients with chronic heart failure followed up at a single center between 2001 and 2006, and found the prevalence of anemia (hemoglobin <12 g/dl for men, <11 g/dl for women) to be 17.2%. At 6-month follow-up, new-onset anemia developed in 16% of patients without prior anemia, whereas 43% patients with anemia at baseline had resolution of their hemoglobin levels. Higher total mortality rates were evident in patients with persistent anemia (58% vs. 31%, p < 0.0001) or with incident anemia (45% vs. 31%, p < 0.0001) compared with those with without anemia at 6 months. This study sought to determine the characteristics and long-term prognosis of anemia in ambulatory patients with chronic heart failure. Anemia is prevalent in heart failure, and may portend poor outcomes. We reviewed 6,159 consecutive outpatients with chronic stable heart failure at baseline, short-term (3-month) follow-up, and long-term (6-month) follow-up between 2001 and 2006. Clinical, demographic, laboratory, and echocardiographic data were reviewed from electronic medical records. Mortality rates were determined from 6-month follow-up to end of study period. Prevalence of anemia (hemoglobin [Hb] <12 g/dl for men, <11 g/dl for women) was 17.2% in our cohort. Diabetes, B-natriuretic peptide, left ventricular ejection fraction, and estimated glomerular filtration rate were independent predictors of baseline anemia. Documented evaluation of anemia was found in only 3% of all anemic patients, and better in internal medicine than in cardiology clinics. At 6-month follow-up, new-onset anemia developed in 16% of patients without prior anemia, whereas 43% patients with anemia at baseline had resolution of their hemoglobin levels. Higher total mortality rates were evident in patients with persistent anemia (58% vs. 31%, p < 0.0001) or with incident anemia (45% vs. 31%, p < 0.0001) compared with those with without anemia at 6 months. These observations in a broad unselected outpatient cohort suggest that anemia in patients with heart failure is under-recognized and underevaluated. However, resolution of anemia was evident in up to 43% of patients who presented initially with anemia, and did not pose greater long-term risk for all-cause mortality. However, the presence of persistent anemia conferred poorest survival in patients with heart failure when compared with that of incident, resolved, or no anemia. |
| Author | Tang, W.H. Wilson, MD, FACC Francis, Gary S., MD, FACC Young, James B., MD, FACC Tong, Wilson, MSc Jain, Anil, MD Harris, C. Martin, MD, MBA |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/18237687$$D View this record in MEDLINE/PubMed |
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| Snippet | Evaluation and Long-Term Prognosis of New-Onset, Transient, and Persistent Anemia in Ambulatory Patients With Chronic Heart Failure W. H. Wilson Tang, Wilson... Evaluation and Long-Term Prognosis of New-Onset, Transient, and Persistent Anemia in Ambulatory Patients With Chronic Heart Failure W. H. Wilson Tang, Wilson... This study sought to determine the characteristics and long-term prognosis of anemia in ambulatory patients with chronic heart failure. Anemia is prevalent in... OBJECTIVESThis study sought to determine the characteristics and long-term prognosis of anemia in ambulatory patients with chronic heart... |
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| SubjectTerms | Age Factors Aged Analysis of Variance Anemia Anemia - complications Anemia - diagnosis Anemia - drug therapy Cardiology Cardiovascular Chronic Disease Clinics Confidence intervals Diabetes Diabetes Complications Drug therapy Female Follow-Up Studies Heart attacks Heart failure Heart Failure - complications Heart Failure - mortality Heart Failure - physiopathology Hemodynamics Hemoglobins - metabolism Humans Internal Medicine Kaplan-Meier Estimate Logistic Models Male Medical prognosis Middle Aged Mortality Odds Ratio Prevalence Prognosis Proportional Hazards Models Renal Insufficiency - complications Risk Factors Survival analysis Transplants & implants Ventricular Function, Left Womens health |
| Title | Evaluation and Long-Term Prognosis of New-Onset, Transient, and Persistent Anemia in Ambulatory Patients With Chronic Heart Failure |
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