Determinantes clínicos y valor pronóstico de la hemoglobina en pacientes hospitalizados con insuficiencia cardiaca sistólica

Redondo-Bermejo, Belén; Pascual-Figal, Domingo A.; Hurtado-Martínez, José A.; Montserrat-Coll, Jorge; Peñafiel-Verdú, Pablo; Pastor‐Pérez, Francisco J.; Giner-Caro, José A.; Valdés‐Chávarri, Mariano

doi:10.1157/13107116

Cited by 10 publications

(5 citation statements)

References 30 publications

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“…The normocytic normochromic nature of anaemia, and the inverse relationship between haematocrit and C-reative protein levels in diabetes support the possible role of inflammation [26]. Haemoglobin concentrations are inversely related with glycated albumin [26] and hyperglycaemia is possibly associated with decreased erythrocytes lifespan [27], indicating a likely contribution of glucose control to anaemia.…”

Section: Discussionmentioning

confidence: 91%

Anaemia, Haemoglobin Level and Cause-Specific Mortality in People with and without Diabetes

et al. 2012

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BackgroundBoth anaemia and cardiovascular disease (CVD) are common in people with diabetes. While individually both characteristics are known to raise mortality risk, their combined influence has yet to be quantified. In this pooling project, we examined the combined impact of baseline haemoglobin levels and existing CVD on all-cause and CVD mortality in people with diabetes. We draw comparison of these effects with those apparent in diabetes-free individuals.Methods/Principal FindingsA combined analyses of 7 UK population-based cohorts resulted in 26,480 study members. There were 946 participants with physician-diagnosed diabetes, 2227 with anaemia [haemoglobin<13 g/dl (men) or <12 (women)], 2592 with existing CVD (stroke, ischaemic heart disease), and 21,396 with none of the conditions. Across diabetes and anaemia subgroups, and using diabetes-free, non-anaemic participants as the referent group, the adjusted hazard ratios (HR) were 1.46 (95% CI: 1.30–1.63) for anaemia, 1.67 (1.45–1.92) for diabetes, and 2.10 (1.55–2.85) for diabetes and anaemia combined. Across combined diabetes, anaemia and CVD subgroups, and compared with non-anaemic, diabetes-free and CVD-free participants, HR (95% CI) for all-cause mortality were 1.49 (1.32–1.69) anaemia, 1.60 (1.46–1.76) for existing CVD, and 1.66 (1.39–1.97) for diabetes alone. Equivalents were 2.13 (1.48–3.07) for anaemia and diabetes, 2.68 (2.14–3.36) for diabetes and existing CVD, and 3.25 (1.88–5.62) for the three combined. Patterns were similar for CVD mortality.Conclusions/SignificanceIndividually, anaemia and CVD confer similar mortality risks in people with diabetes, and are excessively fatal in combination. Screening for anaemia would identify vulnerable diabetic patients whose outcomes can potentially be improved.

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Section: Discussionmentioning

confidence: 91%

Anaemia, Haemoglobin Level and Cause-Specific Mortality in People with and without Diabetes

et al. 2012

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“…Anemia is a common comorbidity in patients with chronic HF, and its prevalence is 10%–50%. A study by O’Meara et al ( 31 ) showed that anemia increases the risk of mortality and hospitalization in patients with HF, whereas another report asserted that anemia only increases mortality and has no effect on repeated hospitalizations ( 32 ). In the present study, hemoglobin level was found to be an independent risk factor for re-hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Relationship between intrarenal renin-angiotensin activity and re-hospitalization in patients with heart failure with reduced ejection fraction

Örsçelik¹

2018

Anatol J Cardiol

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ObjectiveHeart failure (HF) is a clinical syndrome resulting from structural or functional damages. Although clinical trials have shown that the plasma renin–angiotensin system (RAS) activation decreases HF functional status and increases hospitalization for HF patients, the effect of intrarenal RAS activity is still unknown. In this study, we investigated the relationship between the New York Heart Association (NYHA) class, duration, and number of hospitalizations in the previous year and urinary angiotensinogen (UAGT) in patients with HF with reduced ejection fraction (HFrEF).MethodsThis study included 85 patients who had an ejection fraction of <40% and were receiving optimal medical treatment. Among these, 22 were excluded from the study for various reasons. Demographically and biochemically, the remaining 63 patients were compared according to the NYHA functional classes and re-hospitalization status.ResultsWhen the groups were compared in terms of N-terminal pro–B-type natriuretic peptide (NT-proBNP), UAGT, and high-sensitivity C-reactive protein (Hs-CRP), it was found that these parameters were significantly higher in patients who were hospitalized more than two times in the previous year [p<0.001; p=0.007; p<0.001, respectively]. There was a significant correlation between number of hospitalizations and NT-proBNP (r=0.507, p<0.001), Hs-CRP (r=0.511, p<0.001), hemoglobin (r=-0.419, p=0.001), serum sodium (r=-0.26, p=0.04), and systolic blood pressure (r=-0.283, p=0.02). When the independence of multiple correlations was assessed using multiple linear regression analysis, NT-proBNP, Hs-CRP, and hemoglobin levels were independent predictors of re-hospitalization, but this was not the same for UAGT.ConclusionAlthough UAGT levels are high in patients with poor NYHA functional class and repeated hospitalizations, this marker is not valuable for predicting repeated hospitalization in patients with HFrEF. (Anatol J Cardiol 2018; 19: 205-12)

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“…Ishimura et al [17] showed that hemoglobin levels were lower in diabetic patients than in non-diabetic subjects. Redondo-Bermejo et al [18] reported that red cell survival decreased by about 13% in hyperglycemic states. In the present study, hemoglobin concentrations decreased with increased diabetes duration, suggesting an ongoing decline of hemoglobin levels over time in type 2 diabetic patients, consistent with previous studies [19,20].…”

Section: Discussionmentioning

confidence: 99%

Associations between Hemoglobin Concentrations and the Clinical Characteristics of Patients with Type 2 Diabetes

Chung

Cho

Chung

et al. 2012

Korean J Intern Med

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Background/AimsMany studies have demonstrated an association between hemoglobin levels and cardiovascular disease in diabetic patients. The aim of this study was to determine whether there is an association between hemoglobin concentrations and various clinical parameters, including metabolic factors, plasma C-peptide response after a meal tolerance test, and microvascular complications, in Korean patients with type 2 diabetes.MethodsIn total, 337 male patients with type 2 diabetes were recruited. All subjects were subjected to a meal tolerance test and underwent assessment of hemoglobin levels, fasting and postprandial β-cell responsiveness, and microvascular complications.ResultsPatients with lower hemoglobin concentrations had a longer duration of diabetes, a lower body mass index, and lower concentrations of total cholesterol, triglycerides, and low-density lipoprotein cholesterol. They also had lower levels of postprandial C-peptide, Δ C-peptide, and postprandial β-cell responsiveness. They had a higher prevalence of retinopathy and nephropathy. In multivariate analyses, there was a significant association between nephropathy and hemoglobin concentration. Also, hemoglobin concentrations were independently associated with Δ C-peptide levels and postprandial β-cell responsiveness.ConclusionsHemoglobin concentrations are associated with postprandial C-peptide responses and diabetic nephropathy in patients with type 2 diabetes.

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Determinantes clínicos y valor pronóstico de la hemoglobina en pacientes hospitalizados con insuficiencia cardiaca sistólica

Cited by 10 publications

References 30 publications

Anaemia, Haemoglobin Level and Cause-Specific Mortality in People with and without Diabetes

Anaemia, Haemoglobin Level and Cause-Specific Mortality in People with and without Diabetes

Relationship between intrarenal renin-angiotensin activity and re-hospitalization in patients with heart failure with reduced ejection fraction

Associations between Hemoglobin Concentrations and the Clinical Characteristics of Patients with Type 2 Diabetes

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