Abstract 12456: Effective Hemoglobin Level for the Prevention of All-Cause Mortality is Different Between Male and Female Patients With Heart Failure With Preserved Ejection Fraction.

Introduction: The prevalence of anemia is higher in heart failure with preserved left ventricular ejection fraction (HFpEF) than in heart failure with reduced left ventricular ejection fraction. However, little is known about the association of anemia and gender with prognosis in HFpEF patients. Hypothesis: In this study, we investigated the association between anemia, gender, and prognosis in HFpEF patients. We also assessed effective blood hemoglobin (Hb) level in HFpEF patients. Methods: We examined 535 consecutive HFpEF patients (mean age: 78 ± 11 years) in Japanese heart failure syndrome with preserved ejection fraction (JASPER) registry. The cumulative incidence of all-cause mortality and heart failure (HF) re-admission was evaluated by the Kaplan-Meier analysis. Associations between patient characteristics and clinical outcomes were assessed by Cox proportional hazards regression analysis. Results: According to the World Health Organization criteria, the prevalence rate of anemia was 74% in male patients and 70% in female patients. Kaplan-Meier analysis for all-cause mortality demonstrated that anemic patients had poor prognosis compared with non-anemic patients in both male and female HFpEF patients (26.8% vs. 11.2%, p=0.030 and 22.5% vs. 5.8%, p=0.006, respectively). Meanwhile, HF re-admission rate were not statistically different between two groups in both male and female HFpEF patients (27.5% vs. 21.9%, p=0169 and 34.3% vs. 32.7%, p=0.102, respectively). Interestingly, multivariate analysis revealed that only blood Hb level was an independent predictor of all-cause mortality in both male and female HFpEF patients. According to survival classification and regression tree analysis, blood Hb level of 9.4g/dL for male and 12.3g/dL for female were more accurate cut-off value predicting all-cause mortality in HFpEF patients. Conclusions: Althogh blood Hb level is an independent predictor of all-cause death in both male and female HFpEF patients, effective blood Hb level for the prevention of all-cause mortality is different between male and female HFpEF patients. [ABSTRACT FROM AUTHOR]