Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Heart Failure
Prognostic Impact of Anemia in Patients With Chronic Heart Failure　– With Special Reference to Clinical Background: Report From the CHART-2 Study –
Takeshi Yamauchi, Yasuhiko Sakata, Tsuyoshi Takada, Kotaro Nochioka, Masanobu Miura, Soichiro Tadaki, Ryoichi Ushigome, Kenjiro Sato, Takeo Onose, Kanako Tsuji, Ruri Abe, Jun Takahashi, Satoshi Miyata, Hiroaki Shimokawa, on behalf of the CHART-2 investigators
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Keywords: Anemia, Etiology, Heart failure, Left ventricular ejection fraction, Prognosis
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2015 Volume 79 Issue 9 Pages 1984-1993

Editorial (79-9 pp. 1893-1894)
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Abstract

Background:We aimed to elucidate the prognostic impact of anemia with special reference to the clinical background of patients with chronic heart failure (CHF).Methods and Results:We examined 4,646 consecutive patients with Stage C/D CHF registered in the Chronic Heart Failure Analysis and Registry in the Tohoku District-2 (CHART-2) Study (n=10,219). Among them, 1,627 (35%) had anemia and were characterized by higher age (74 vs. 66 years), lower estimated glomerular filtration rate (52.8 vs. 66.1 ml/min/1.73 m2) and higher B-type natriuretic peptide levels (154.5 vs. 81.8 pg/ml) (all P<0.001) but comparable left ventricular ejection fraction (LVEF; 57.5 vs. 56.7%). Anemic patients were more frequently treated with diuretics (55.1 vs. 42.3%) but less often treated with β-blockers (45.4 vs. 51.1%) (both P<0.001). During a median follow-up of 3.8 years, 371 and 272 patients died with and without anemia, respectively (22.8 vs. 9.0%, adjusted hazard ratio 1.40; 95% confidence interval 1.15–1.71, P=0.001). Subgroup analysis revealed that the prognostic impact of anemia was comparable in terms of age, sex, renal function and double product, but differed by LVEF level and CHF etiology (both, P for interaction <0.001). In particular, a difference in the prognostic impact of LVEF level was noted in patients with ischemic heart disease.Conclusions:These results indicate that the prognostic impact of anemia is evident in CHF patients with preserved EF and it differs by CHF etiology. (Circ J 2015; 79: 1984–1993)

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© 2015 THE JAPANESE CIRCULATION SOCIETY
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