The cardiorenal anaemia syndrome in systolic heart failure: prevalence, clinical correlates, and long-term survival.
Summary of "The cardiorenal anaemia syndrome in systolic heart failure: prevalence, clinical correlates, and long-term survival."
AIMS:
We sought to assess the prevalence and clinical correlates of cardiorenal anaemia (CRA) syndrome in systolic heart failure and the relationship between renal dysfunction and anaemia on hard clinical outcomes. METHODS AND
RESULTS:
We studied 951 patients with chronic heart failure (CHF) and systolic dysfunction. The primary outcome was all-cause mortality and urgent heart transplantation (UHT). Cox's regression analyses were used to assess the relation of the variables to the primary outcome. Hazard ratios (HRs) with 95% confidence intervals (CI) were calculated. The prevalence of CRA syndrome was 21.1%. Age (P < 0.001), body mass index (P< 0.001), diabetes (P =< 0.001), ischaemic aetiology (P< 0.006), left ventricular ejection fraction (P= 0.018), and treatment with renin-angiotensin system inhibitors (P< 0.001) were independently related to CRA syndrome. During a median follow-up of 3.7 years, the primary outcome occurred in 404 patients (42.5%). Compared with patients with preserved renal function and normal haemoglobin (Hb) levels, those with CRA syndrome had a significantly increased risk for the primary outcome; the univariate and multivariate-adjusted HRs were 4.04 (
CI:
3.11-5.24; P< 0.0001) and 2.22 (
CI:
1.64-2.98; P< 0.0001), respectively. Three-year UHT-free survival was 86 and 47%, respectively. Among patients with renal dysfunction, the adjusted HR for the primary outcome increased by 17% (
CI:
8-26; P= 0.0001) for each 1g/dL decrease below an Hb value of 13.0 g/dL.
CONCLUSION:
Heart failure, renal dysfunction, and anaemia are a fatal combination. Despite a relatively low prevalence, the CRA syndrome contributes to considerable mortality due to CHF.
Affiliation
Division of Cardiology and Cardiac Rehabilitation, 'S. Maugeri' Foundation, IRCCS, Institute of Cassano Murge, 70020 Cassano Murge , Bari, Italy.
Journal Details
This article was published in the following journal.
Name: European journal of heart failure : journal of the Working Group on Heart Failure of the European Society of Cardiology
ISSN: 1879-0844
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20858705
- DOI: http://dx.doi.org/10.1093/eurjhf/hfq167
Medical and Biotech [MESH] Definitions
Cardiomegaly
Enlargement of the HEART, usually indicated by a cardiothoracic ratio above 0.50. Heart enlargement may involve the right, the left, or both HEART VENTRICLES or HEART ATRIA. Cardiomegaly is a nonspecific symptom seen in patients with chronic systolic heart failure (HEART FAILURE) or several forms of CARDIOMYOPATHIES.
Heart Failure, Systolic
Heart failure caused by abnormal myocardial contraction during SYSTOLE leading to defective cardiac emptying.
Heart Failure
A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (VENTRICULAR DYSFUNCTION), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as MYOCARDIAL INFARCTION.
Systolic Murmurs
Heart murmurs which are systolic in timing. They occur between the first and the second HEART SOUNDS, between the closure of MITRAL VALVE and TRICUSPID VALVE and the closure of semilunar aortic and pulmonary valves. Systolic murmurs include ejection murmurs and regurgitant murmurs.
Xamoterol
A selective beta-1-adrenergic partial agonist. Because it is a partial agonist (DRUG PARTIAL AGONISM) it acts like an agonist when sympathetic activity is low and as an antagonist when sympathetic activity is high. It reduces MYOCARDIAL ISCHEMIA and improves ventricular function in patients with mild to moderate heart failure. In patients with severe heart failure it has been shown to produce benefits in systolic and diastolic function.
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