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Impact of Acute Hemoglobin Falls in Heart Failure Patients: A Population Study

Aims: This study assessed the impact of acute hemoglobin (Hb) falls in heart failure (HF) patients. Methods: HF patients with repeated Hb values over time were included. Falls in Hb greater than 30% were considered to represent an acute episode of anemia and the risk of hospitalization and all-cause...

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Autores principales: Lopez, Cristina, Holgado, Jose Luis, Fernandez, Antonio, Sauri, Inmaculada, Uso, Ruth, Trillo, Jose Luis, Vela, Sara, Bea, Carlos, Nuñez, Julio, Ferrer, Ana, Gamez, Javier, Ruiz, Adrian, Redon, Josep
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355985/
https://www.ncbi.nlm.nih.gov/pubmed/32549339
http://dx.doi.org/10.3390/jcm9061869
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author Lopez, Cristina
Holgado, Jose Luis
Fernandez, Antonio
Sauri, Inmaculada
Uso, Ruth
Trillo, Jose Luis
Vela, Sara
Bea, Carlos
Nuñez, Julio
Ferrer, Ana
Gamez, Javier
Ruiz, Adrian
Redon, Josep
author_facet Lopez, Cristina
Holgado, Jose Luis
Fernandez, Antonio
Sauri, Inmaculada
Uso, Ruth
Trillo, Jose Luis
Vela, Sara
Bea, Carlos
Nuñez, Julio
Ferrer, Ana
Gamez, Javier
Ruiz, Adrian
Redon, Josep
author_sort Lopez, Cristina
collection PubMed
description Aims: This study assessed the impact of acute hemoglobin (Hb) falls in heart failure (HF) patients. Methods: HF patients with repeated Hb values over time were included. Falls in Hb greater than 30% were considered to represent an acute episode of anemia and the risk of hospitalization and all-cause mortality after the first episode was assessed. Results: In total, 45,437 HF patients (54.9% female, mean age 74.3 years) during a follow-up average of 2.9 years were analyzed. A total of 2892 (6.4%) patients had one episode of Hb falls, 139 (0.3%) had more than one episode, and 342 (0.8%) had concomitant acute kidney injury (AKI). Acute heart failure occurred in 4673 (10.3%) patients, representing 3.6/100 HF patients/year. The risk of hospitalization increased with one episode (Hazard Ratio = 1.30, 95% confidence interval (CI) 1.19–1.43), two or more episodes (HR = 1.59, 95% CI 1.14–2.23, and concurrent AKI (HR = 1.61, 95% CI 1.27–2.03). A total of 10,490 patients have died, representing 8.1/100 HF patients/year. The risk of mortality was HR = 2.20 (95% CI 2.06–2.35) for one episode, HR = 3.14 (95% CI 2.48–3.97) for two or more episodes, and HR = 3.20 (95% CI 2.73–3.75) with AKI. In the two or more episodes and AKI groups, Hb levels at the baseline were significantly lower (10.2–11.4 g/dL) than in the no episodes group (12.8 g/dL), and a higher and significant mortality in these subgroups was observed. Conclusions: Hb falls in heart failure patients identified those with a worse prognosis requiring a more careful evaluation and follow-up.
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spelling pubmed-73559852020-07-22 Impact of Acute Hemoglobin Falls in Heart Failure Patients: A Population Study Lopez, Cristina Holgado, Jose Luis Fernandez, Antonio Sauri, Inmaculada Uso, Ruth Trillo, Jose Luis Vela, Sara Bea, Carlos Nuñez, Julio Ferrer, Ana Gamez, Javier Ruiz, Adrian Redon, Josep J Clin Med Article Aims: This study assessed the impact of acute hemoglobin (Hb) falls in heart failure (HF) patients. Methods: HF patients with repeated Hb values over time were included. Falls in Hb greater than 30% were considered to represent an acute episode of anemia and the risk of hospitalization and all-cause mortality after the first episode was assessed. Results: In total, 45,437 HF patients (54.9% female, mean age 74.3 years) during a follow-up average of 2.9 years were analyzed. A total of 2892 (6.4%) patients had one episode of Hb falls, 139 (0.3%) had more than one episode, and 342 (0.8%) had concomitant acute kidney injury (AKI). Acute heart failure occurred in 4673 (10.3%) patients, representing 3.6/100 HF patients/year. The risk of hospitalization increased with one episode (Hazard Ratio = 1.30, 95% confidence interval (CI) 1.19–1.43), two or more episodes (HR = 1.59, 95% CI 1.14–2.23, and concurrent AKI (HR = 1.61, 95% CI 1.27–2.03). A total of 10,490 patients have died, representing 8.1/100 HF patients/year. The risk of mortality was HR = 2.20 (95% CI 2.06–2.35) for one episode, HR = 3.14 (95% CI 2.48–3.97) for two or more episodes, and HR = 3.20 (95% CI 2.73–3.75) with AKI. In the two or more episodes and AKI groups, Hb levels at the baseline were significantly lower (10.2–11.4 g/dL) than in the no episodes group (12.8 g/dL), and a higher and significant mortality in these subgroups was observed. Conclusions: Hb falls in heart failure patients identified those with a worse prognosis requiring a more careful evaluation and follow-up. MDPI 2020-06-15 /pmc/articles/PMC7355985/ /pubmed/32549339 http://dx.doi.org/10.3390/jcm9061869 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lopez, Cristina
Holgado, Jose Luis
Fernandez, Antonio
Sauri, Inmaculada
Uso, Ruth
Trillo, Jose Luis
Vela, Sara
Bea, Carlos
Nuñez, Julio
Ferrer, Ana
Gamez, Javier
Ruiz, Adrian
Redon, Josep
Impact of Acute Hemoglobin Falls in Heart Failure Patients: A Population Study
title Impact of Acute Hemoglobin Falls in Heart Failure Patients: A Population Study
title_full Impact of Acute Hemoglobin Falls in Heart Failure Patients: A Population Study
title_fullStr Impact of Acute Hemoglobin Falls in Heart Failure Patients: A Population Study
title_full_unstemmed Impact of Acute Hemoglobin Falls in Heart Failure Patients: A Population Study
title_short Impact of Acute Hemoglobin Falls in Heart Failure Patients: A Population Study
title_sort impact of acute hemoglobin falls in heart failure patients: a population study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355985/
https://www.ncbi.nlm.nih.gov/pubmed/32549339
http://dx.doi.org/10.3390/jcm9061869
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