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Clinical correlates and consequences of anemia in a broad spectrum of patients with heart failure: results of the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) Program.
- Source :
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Circulation [Circulation] 2006 Feb 21; Vol. 113 (7), pp. 986-94. Date of Electronic Publication: 2006 Feb 13. - Publication Year :
- 2006
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Abstract
- Background: We wished to determine the prevalence of, potential mechanistic associations of, and clinical outcomes related to anemia in patients with heart failure and a broad spectrum of left ventricular ejection fraction (LVEF).<br />Methods and Results: In multivariable analyses, we examined the associations between hemoglobin and baseline characteristics, laboratory variables, and outcomes in 2653 patients randomized in the CHARM Program in the United States and Canada. Anemia was equally common in patients with preserved (27%) and reduced (25%) LVEF but was more common in black and older patients. Anemia was associated with ethnicity, diabetes, low body mass index, higher systolic and lower diastolic blood pressure, and recent heart failure hospitalization. More than 50% of anemic patients had a glomerular filtration rate <60 mL.min(-1).1.73 m(-2) compared with <30% of nonanemic patients. Despite an inverse relationship between hemoglobin and LVEF, anemia was associated with an increased risk of death and hospitalization, a relationship observed in patients with both reduced and preserved LVEF. There were 133 versus 69 deaths and 527 versus 352 hospitalizations per 1000 patient-years of follow-up in anemic versus nonanemic patients (both P<0.001). The effect of candesartan in reducing outcomes was independent of hemoglobin.<br />Conclusions: Anemia was common in heart failure, regardless of LVEF. Lower hemoglobin was associated with higher LVEF yet was an independent predictor of adverse mortality and morbidity outcomes. In heart failure, the causes of anemia and the associations between anemia and outcomes are probably multiple and complex.
- Subjects :
- Aged
Anemia epidemiology
Benzimidazoles pharmacology
Biphenyl Compounds
Female
Glomerular Filtration Rate
Heart Failure epidemiology
Hemoglobins analysis
Hospitalization
Humans
Male
Middle Aged
Multivariate Analysis
Prevalence
Racial Groups
Risk Factors
Stroke Volume
Tetrazoles pharmacology
Treatment Outcome
Anemia etiology
Anemia mortality
Heart Failure complications
Heart Failure mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4539
- Volume :
- 113
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Circulation
- Publication Type :
- Academic Journal
- Accession number :
- 16476847
- Full Text :
- https://doi.org/10.1161/CIRCULATIONAHA.105.582577