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Prognostic value of new-onset anemia as a marker of hemodilution in patients with acute decompensated heart failure and severe renal dysfunction

 Namki Hong  ;  Jong-Chan Youn  ;  Jaewon Oh  ;  Hye Sun Lee  ;  Sungha Park  ;  Donghoon Choi  ;  Seok-Min Kang 
 JOURNAL OF CARDIOLOGY, Vol.64(1) : 43-48, 2014 
Journal Title
Issue Date
Acute Disease ; Aged ; Anemia*/blood ; Anemia*/epidemiology ; Biomarkers ; Cardiovascular Diseases*/epidemiology ; Cardiovascular Diseases*/etiology ; Female ; Follow-Up Studies ; Heart Failure*/blood ; Humans ; Kidney Diseases*/blood ; Male ; Middle Aged ; Predictive Value of Tests ; Prevalence ; Prognosis ; Retrospective Studies ; Risk ; Severity of Illness Index ; Time Factors
Heart failure ; Hemodynamics ; Prognosis ; Renal function
BACKGROUND AND PURPOSE:In patients with acute decompensated heart failure (ADHF), the prognostic value of new-onset anemia with regard to renal function has not been investigated. METHODS AND SUBJECTS:Consecutive 299 ADHF patients (162 men, 62 ± 14 years) were enrolled. Cardiovascular (CV) events composite of CV mortality and rehospitalization occurred in 113 patients (37.8%) during 2 years of follow-up. RESULTS:Baseline anemia was prevalent (n = 124, 41.5%) and 43 patients (14.4%) had new-onset anemia at 1 month after discharge. Baseline anemia was strongly associated with CV events risk in overall [hazard ratio (HR): 1.79, 95% CI: 1.17-2.74, p = 0.006] and those with preserved renal function [estimated glomerular filtration rate (eGFR)≥ 45 mL/min/1.73 m(2)] (HR: 1.81, 95% CI: 1.05-3.12, p = 0.031). In patients with severe renal dysfunction (eGFR<45 mL/min/1.73 m(2)), new-onset anemia independently predicted CV events (HR: 2.72, 95% CI: 1.09-6.76, p = 0.031) whereas baseline anemia did not (HR: 1.28, 95% CI: 0.61-2.65, p = 0.505). New-onset anemia was significantly associated with hemodilution, which may reflect inadequate decongestion in ADHF patients. CONCLUSIONS:Baseline anemia was an independent prognostic factor in overall ADHF patients and those with preserved renal function. New-onset anemia as a surrogate for hemodilution better predicted CV events than baseline anemia in ADHF patients with severe renal dysfunction.
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1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Oh, Jae Won(오재원) ORCID logo https://orcid.org/0000-0002-4585-1488
Youn, Jong Chan(윤종찬)
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Nam Ki(홍남기) ORCID logo https://orcid.org/0000-0002-8246-1956
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