Anemia and heart failure: a community study.
Anemia and heart failure: a community study.
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DOI：
10.1016/j.amjmed.2008.03.039
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发表时间：
2008-08
影响因子：
5.9
通讯作者：
Roger, Veronique L.
中科院分区：
文献类型：
--
作者：
Dunlay, Shannon M.;Weston, Susan A.;Redfield, Margaret M.;Killian, Jill M.;Roger, Veronique L.
贫血是心力衰竭的重要合并症，与死亡率增加有关。本研究的目的是确定社区心力衰竭人群中贫血的患病率，检查随时间推移的患病率趋势，并评估贫血在射血分数保留和降低的心力衰竭患者中的作用。对两组患有心力衰竭的奥姆斯特德县居民进行了检查。回顾性队列包括 1979 年至 2002 年发生的心力衰竭病例 (n=1063)。前瞻性队列包括 2003 年至 2006 年的活动性心力衰竭病例 (n=677)。收集临床特征。贫血症由世界卫生组织标准定义。回顾性队列中贫血患病率为 40%，前瞻性队列中贫血患病率为 53%。 1979 年至 2002 年间，贫血患病率估计增加了 16%（p=0.008），2003-2006 年间，射血分数保留（≥50%）的患者与射血分数降低（<50%）的患者相比，贫血患病率更高（分别为 58% 和 48%，p<0.001）。贫血与死亡风险大幅增加相关（两组均 p<0.001）。死亡率与血红蛋白之间的关系呈 J 形曲线，血红蛋白低于 14mg/dL 和高于 16mg/dL 时死亡率增加。在前瞻性队列中，调整临床特征后，以血红蛋白14-16mg/dL为参照，血红蛋白≥16mg/dL的死亡HR（95%CI）为3.07（1.26-6.82），血红蛋白<10mg/dL的死亡HR（95%CI）为2.39（1.37-4.27）。在社区中，一半的心力衰竭患者患有贫血，并且贫血的患病率随着时间的推移而增加。贫血在射血分数保留的心力衰竭中更为普遍，并且与死亡率大幅增加相关。
Anemia is an important comorbidity in heart failure, and has been associated with increased mortality. The goals of this study were to define the prevalence of anemia in a community heart failure population, examine trends in prevalence over time, and evaluate the role of anemia in heart failure patients with preserved and reduced ejection fraction. Two cohorts of Olmsted County residents with heart failure were examined. The retrospective cohort included incident heart failure cases from 1979–2002 (n=1063). The prospective cohort included active heart failure cases from 2003–2006 (n=677). Clinical characteristics were collected. Anemia was defined by WHO criteria. The prevalence of anemia was 40% in the retrospective and 53% in the prospective cohorts. Anemia prevalence increased by an estimated 16% between 1979 and 2002 (p=0.008), and was higher in those with preserved (≥50%), vs. reduced (<50%) ejection fraction (58% vs. 48%, respectively, p<0.001) from 2003–2006. Anemia was associated with a large increase in the risk of death (p<0.001 both cohorts). The relationship between mortality and hemoglobin followed a J-shaped curve, with increased mortality with hemoglobin below 14mg/dL and above 16mg/dL. In the prospective cohort, after adjustment for clinical characteristics, the HR(95%CI) for death were 3.07(1.26–6.82) in those with hemoglobin ≥16mg/dL and 2.39(1.37–4.27) in those with hemoglobin<10mg/dL using hemoglobin 14–16mg/dL as the referent. In the community half of heart failure patients are anemic, and the prevalence of anemia increased over time. Anemia is more prevalent in heart failure with preserved ejection fraction and is associated with a large increase in mortality.
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DOI：
10.1016/s0735-1097(03)00425-x
发表时间：
2003-06-04
影响因子：
24
作者：
Mozaffarian, D;Nye, R;Levy, WC
通讯作者：
Levy, WC
影响因子：
37.8
作者：
Mancini, DM;Katz, SD;Androne, AS
通讯作者：
Androne, AS
影响因子：
5
作者：
KANNEL, WB;FEINLEIB, M;CASTELLI, WP
通讯作者：
CASTELLI, WP
影响因子：
5.9
作者：
Kosiborod, M;Smith, GL;Krumholz, HM
通讯作者：
Krumholz, HM
影响因子：
24
作者：
Ponikowski, Piotr;Anker, Stefan D.;McDonald, Ken
通讯作者：
McDonald, Ken