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

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

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)≥45mL/min/1.73m2] (HR: 1.81, 95% CI: 1.05-3.12, p=0.031). In patients with severe renal dysfunction (eGFR<45mL/min/1.73m2), 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.

Original languageEnglish
Pages (from-to)43-48
Number of pages6
JournalJournal of Cardiology
Volume64
Issue number1
DOIs
Publication statusPublished - 2014 Jul

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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