Outcomes of patients with anemia and renal dysfunction in hospitalized heart failure with preserved ejection fraction (from the CN-HF registry)

Jin, Xuejuan; Cao, Juan; Zhou, Jun; Wang, Yanyan; Han, Xueting; Song, Yu; Fan, Yuyuan; Chen, Zhenyue; Xu, Dingli; Yang, Xinchun; Dong, Wei; Liu, Liwen; Chen, Li; Zhong, Qian; Fu, Michael; Hu, Kai; Zhou, Jingmin; Ge, Junbo; investigators, Cn-Hf

doi:10.1016/j.ijcha.2019.100415

Cited by 8 publications

(24 citation statements)

References 34 publications

(41 reference statements)

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“…In the included studies, three studies defined that their patients suffered from acute HF ( 31 , 32 , 44 ) and one had reported that they included cases with both acute and chronic HF ( 26 ). The rest of the seven studies did not provide details concerning the nature of the HF cases they included ( 23 – 26 , 30 , 41 , 42 ). Besides, five of the included studies had also reported the ejection fraction values for their sample ( 23 , 30 , 32 , 41 , 42 ).…”

Section: Resultsmentioning

confidence: 99%

“…The rest of the seven studies did not provide details concerning the nature of the HF cases they included ( 23 – 26 , 30 , 41 , 42 ). Besides, five of the included studies had also reported the ejection fraction values for their sample ( 23 , 30 , 32 , 41 , 42 ). The average ejection fraction for all the included studies was found to be 47.5 ± 15.2% for the HF patients with anemia, and 44.9 ± 15.6% for the HF patients without anemia.…”

Section: Resultsmentioning

confidence: 99%

“…The average ejection fraction for all the included studies was found to be 47.5 ± 15.2% for the HF patients with anemia, and 44.9 ± 15.6% for the HF patients without anemia. Moreover, the HF was defined by seven of the included studies with echocardiography ( 23 , 24 , 30 , 32 , 41 , 42 , 44 ), one study used the NT-proB-type Natriuretic Peptide blood test ( 25 ), and three studies did not define their measures for identifying HF ( 26 , 31 , 43 ).…”

Section: Resultsmentioning

confidence: 99%

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The Prognostic Significance of Anemia in Patients With Heart Failure: A Meta-Analysis of Studies From the Last Decade

Xia

Shen

Cha

et al. 2021

Front. Cardiovasc. Med.

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Background: Anemia is a commonly occurring comorbidity in patients with heart failure (HF). Although there are a few reports of a higher prevalence of mortality and hospitalization-related outcomes due to accompanying anemia, other studies suggest that anemia does not have an adverse impact on the prognostic outcomes of HF. Two meta-analyses in the past decade had reported the adverse impact of anemia on both mortality and hospitalization- related outcomes. However, only one of these studies had evaluated the outcome while using multivariable adjusted hazard ratios. Moreover, several studies since then reported the prognostic influence of anemia in HF. In this present study, we evaluate the prognostic impact of anemia on mortality and hospitalization outcomes in patients with HF.Methods: We carried out a systematic search of the academic literature in the scientific databases EMBASE, CENTRAL, Scopus, PubMed, Cochrane, ISI Web of Science, clinicaltrial.gov, and MEDLINE based on the PRISMA guidelines. Meta-analysis was then performed to evaluate the effect (presented as risk ratio) of anemia on the overall mortality and hospitalization outcome in patients with HF.Results: Out of 1,397 studies, 11 eligible studies were included with a total of 53,502 (20,615 Female, 32,887 Male) HF patients (mean age: 71.6 ± 8.3-years, Hemoglobin: 11.9 ± 1.5 g/dL). Among them, 19,794 patients suffered from anemia (Hb: 10.5 ± 1.6), and 33,708 patients did not have anemia (Hb: 13.2 ± 1.7 g/dL). A meta-analysis revealed a high-odds ratio (OR) for the overall mortality in patients with anemia (OR: 1.43, 95% CI: 1.29–1.84). A high-risk ratio was also reported for hospitalization as the outcome in patients with anemia (1.22, 1.0–1.58).Conclusion: This systematic review and meta-analysis provide evidence of the high risk of mortality and hospitalization-related outcomes in patients with HF and anemia. The study confirms the findings of previously published meta-analyses suggesting anemia as an important and independent risk factor delineating the prognostic outcome of chronic HF.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The Prognostic Significance of Anemia in Patients With Heart Failure: A Meta-Analysis of Studies From the Last Decade

Xia

Shen

Cha

et al. 2021

Front. Cardiovasc. Med.

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“…While these studies are very heterogeneous, the results have always been consistent and similar to those of the present study. [15][16][17][18][19][20][21][22][23] The differences which make our study of interest are the large sample size analysed, and that it is the first study to include all patients consulting for AHF in ED, since other studies only included patients who were hospitalised or were outpatients. We believe this circumstance to be important since up to one-quarter of the patients with AHF do not require admission and are usually excluded from this type of analysis.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, studies including AHF episodes only analyse hospitalised patients. [15][16][17][18][19][20][21][22][23] The objective of this study was to analyse the differential characteristics of patients with AHF presenting criteria of CRAS at arrival at the hospital emergency department (ED) and the impact RD and anaemia have, individually and in combination in patients with CRAS, on the short-term events during the episode of decompensation.…”

Section: Introductionmentioning

confidence: 99%

The CRAS-EAHFE study: Characteristics and prognosis of acute heart failure episodes with cardiorenal-anaemia syndrome at the emergency department

Llauger

Jacob

Herrero‐Puente

et al. 2020

European Heart Journal. Acute Cardiovascular Care

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Background The coexistence of other comorbidities confers poor outcomes in patients with acute heart failure. Our aim was to determine the characteristics of patients with acute heart failure and cardiorenal anaemia syndrome and the relationship between renal dysfunction and anaemia, alone or combined as cardiorenal anaemia syndrome, on short-term outcomes. Methods We analysed the Epidemiology of Acute Heart Failure in Emergency Departments registry (cohort of patients with acute heart failure in Spanish emergency departments). Renal dysfunction was defined by an estimated glomerular filtration rate <60 ml/min/m2, anaemia by haemoglobin values <12/<13 g/dl in women/men, and cardiorenal anaemia syndrome as the presence of both. Comparisons were made according to cardiorenal-anaemia syndrome positive (CRAS+) with respect to the rest of patients (CRAS–) and according the presence of renal dysfunction (RD+) and anaemia (A+), (alone, RD+/A–, RD–/A+) or in combination (RD+/A+; i.e. CRAS+) with respect to patients without renal dysfunction and anaemia (RD–/A–). The primary outcome was 30-day mortality, and the secondary outcomes were need for admission, prolonged hospitalisation (>10 days), in-hospital mortality during the index event, and reconsultation and the combination of 30-day post-discharge reconsultation/death. These short-term outcomes were compared and adjusted for differences among groups. Results Of the 13,307 patients analysed, CRAS+ (36.4%) was associated with older age, multiple comorbidities, chronic use of loop diuretics, oedemas and hypotension. The 30-day mortality in CRAS+ was greater than in CRAS– (hazard ratio = 1.46, 95% confidence interval = 1.26–1.68) and RD–/A– (hazard ratio = 1.83, 95% confidence interval = 1.46–2.28) control groups. The mortality level was also higher in RD+/A– (hazard ratio = 1.40, 95% confidence interval = 1.10–1.78) and higher, but not statistically significant, in RD–/A+ (hazard ratio = 1.28, 95% confidence interval = 0.99–1.63) with respect to RD–/A–. All of the secondary outcomes, when related to CRAS– and RD–/A– control groups, were worse for CRAS+ and to a lesser extent, RD+/A–, being more rarely observed in RD–/A+. Conclusions Cardiorenal anaemia syndrome in acute heart failure is related to greater mortality and worse short-term outcomes, and the impact of renal dysfunction and anaemia seems to be additive.

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Clinical outcomes by serum potassium levels for patients hospitalized for heart failure: Secondary analysis of data from the China National Heart Failure Registry

Zhou

Jin

Zhou

et al. 2023

Clinical Cardiology

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BackgroundDyskalemia is a mortality risk factor in patients with heart failure (HF).HypothesisWe described the prevalence of dyskalemia, and clinical outcomes by serum potassium (sK) levels, in Chinese patients hospitalized for HF.MethodsIn this secondary analysis of the prospective China National Heart Failure Registry, adult patients hospitalized between January 1, 2013 and June 30, 2015 who had at least one baseline sK measurement were followed for up to 3 years after discharge. The use of renin–angiotensin–aldosterone system inhibitors at baseline and clinical outcomes during follow‐up were compared among sK groups.ResultsAmong 6950 patients, 5529 (79.6%) had normokalemia (sK >3.5–5.0 mmol/L), 1113 (16.0%) had hypokalemia (sK 0–3.5 mmol/L), and 308 (4.4%) had hyperkalemia (sK >5.0 mmol/L). Baseline characteristics that were most common in patients with hyperkalemia than those with hypo‐ and normokalemia included older age, HF with reduced ejection fraction, New York Heart Association Class III/IV status, hypertension, and chronic kidney disease. Use of angiotensin‐converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) differed across sK groups (p = .0001); reported in 64.1%, 63.4%, and 54.5% of patients with hypo‐, normo‐, and hyperkalemia, respectively. Overall, 26.6%, 28.6%, and 36.0% of patients with hypo‐, normo‐, and hyperkalemia had rehospitalization for worsened HF, or cardiovascular mortality; p = .0057 for between‐group comparison.ConclusionsPatients with hyperkalemia received ACEIs or ARBs for HF treatment at baseline less frequently than those with hypo‐ or normokalemia, and had worse prognoses. This warrants further investigation into effective hyperkalemia management in HF.

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Outcomes of patients with anemia and renal dysfunction in hospitalized heart failure with preserved ejection fraction (from the CN-HF registry)

Cited by 8 publications

References 34 publications

The Prognostic Significance of Anemia in Patients With Heart Failure: A Meta-Analysis of Studies From the Last Decade

The Prognostic Significance of Anemia in Patients With Heart Failure: A Meta-Analysis of Studies From the Last Decade

The CRAS-EAHFE study: Characteristics and prognosis of acute heart failure episodes with cardiorenal-anaemia syndrome at the emergency department

Clinical outcomes by serum potassium levels for patients hospitalized for heart failure: Secondary analysis of data from the China National Heart Failure Registry

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