The Prognostic Value of Anemia in Patients with Preserved, Mildly Reduced and Recovered Ejection Fraction

Pintér, Anita and Behon, Anett and Veres, Boglárka and Merkel, Eperke Dóra and Schwertner, Walter Richárd and Kuthi, Luca Katalin and Masszi, Richárd and Lakatos, Bálint Károly and Kovács, Attila and Becker, Dávid and Merkely, Béla and Kosztin, Annamária (2022) The Prognostic Value of Anemia in Patients with Preserved, Mildly Reduced and Recovered Ejection Fraction. DIAGNOSTICS, 12 (2). pp. 1-14. ISSN 2075-4418

Preview

Text diagnostics-12-00517.pdf Available under License Creative Commons Attribution. Download (1MB) | Preview

Abstract

Data on the relevance of anemia in heart failure (HF) patients with an ejection fraction (EF) > 40% by subgroup—preserved (HFpEF), mildly reduced (HFmrEF) and the newly defined recovered EF (HFrecEF)—are scarce. Patients with HF symptoms, elevated NT-proBNP, EF ≥ 40% and structural abnormalities were registered in the HFpEF-HFmrEF database. We described the outcome of our HFpEF-HFmrEF cohort by the presence of anemia. Additionally, HFrecEF patients were also selected from HFrEF patients who underwent resynchronization and, as responders, reached 40% EF. Using propensity score matching (PSM), 75 pairs from the HFpEF-HFmrEF and HFrecEF groups were matched by their clinical features. After PMS, we compared the survival of the HFpEF-HFmrEF and HFrecEF groups. Log-rank, uni-and multivariate regression analyses were performed. From 375 HFpEF-HFmrEF patients, 42 (11%) died during the median follow-up time of 1.4 years. Anemia (HR 2.77; 95%CI 1.47–5.23; p < 0.01) was one of the strongest mortality predictors, which was also confirmed by the multivariate analysis (aHR 2.33; 95%CI 1.21–4.52; p = 0.01). Through PSM, the outcomes for HFpEF-HFmrEF and HFrecEF patients with anemia were poor, exhibiting no significant difference. In HFpEF-HFmrEF, anemia was an independent mortality predictor. Its presence multiplied the mortality risk in those with EF ≥ 40%, regardless of HF etiology.

Actions (login required)

Edit Item