Title: | Anemia has an impact on prognosis in heart failure with preserved ejection fraction with mild chronic kidney disease |
Authors: | Okuno, Keisuke Browse this author |
Naito, Yoshiro Browse this author |
Asakura, Masanori Browse this author |
Sugahara, Masataka Browse this author |
Horimatsu, Tetsuo Browse this author |
Yasumura, Seiki Browse this author |
Tahara, Saki Browse this author |
Nagai, Toshiyuki Browse this author |
Saito, Yoshihiko Browse this author |
Yoshikawa, Tsutomu Browse this author |
Masuyama, Tohru Browse this author |
Ishihara, Masaharu Browse this author |
Anzai, Toshihisa Browse this author →KAKEN DB |
Keywords: | Anemia |
Chronic kidney disease |
Hemoglobin |
Heart failure with preserved left ventricular ejection fraction |
Issue Date: | Jun-2021 |
Publisher: | Elsevier |
Journal Title: | IJC Heart & vasculature |
Volume: | 34 |
Start Page: | 100796 |
Publisher DOI: | 10.1016/j.ijcha.2021.100796 |
Abstract: | Background: Anemia and chronic kidney disease (CKD) are common in patients with heart failure with preserved left ventricular fraction (HFpEF). However, it is entirely unknown about the impact of anemia on prognosis in HFpEF patients with CKD. In this study, we investigated the impact of anemia on prognosis and the optimal hemoglobin (Hb) levels to predict prognosis in HFpEF patients with CKD. Methods and Results: We prospectively examined 523 consecutive HFpEF patients enrolled in Japanese heart failure syndrome with preserved ejection fraction registry. CKD was defined as an estimated glomerular filtration rate (eGFR) of <60 mL /min/1.73 m(2). The prevalence rate of anemia was 78% in HFpEF patients with CKD by using the World Health Organization criteria. Kaplan-Meier analysis for all-cause mortality and heart failure rehospitalization demonstrated that anemic patients had poor prognosis compared with non-anemic patients in HFpEF patients with CKD, but not those without CKD. According to the degree of CKD, anemia affected prognosis in HFpEF patients with mild CKD (45 <= eGFR < 60), but not those with moderate to severe CKD (15 <= eGFR < 45). Additionally, multivariate analysis revealed that anemia and Hb levels were independent predictors of composite outcomes in HFpEF patients with mild CKD, but not those with moderate to severe CKD. Finally, survival classification and regression tree analysis showed that the optimal Hb levels to predict composite outcomes were 10.7 g/dL in those with mild CKD. Conclusions: Anemia has an impact on prognosis in HFpEF patients, especially among those with mild CKD. (C) 2021 The Authors. Published by Elsevier B.V. |
Type: | article |
URI: | http://hdl.handle.net/2115/82553 |
Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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