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Anemia has an impact on prognosis in heart failure with preserved ejection fraction with mild chronic kidney disease

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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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