Anaemia and coronary artery disease severity in patients with heart failure.
Anaemia and coronary artery disease severity in patients with heart failure.
复制标题
心力衰竭患者的贫血和冠状动脉疾病的严重程度。
DOI：
10.1016/j.ejheart.2005.05.004
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发表时间：
2006
影响因子：
18.2
通讯作者：
O'Connor,ChristopherM
中科院分区：
文献类型：
--
作者：
Felker,GMichael;Stough,WendyGattis;Shaw,LindaK;O'Connor,ChristopherM
贫血是心力衰竭（HF）患者常见的并发症，与高死亡率相关。心力衰竭、冠心病、AimsThe目的本研究的目的是评估更严重的CAD会加重HF患者贫血的不良反应的假设。方法我们检查了有症状的心力衰竭患者的数据，1995年至2003年期间接受冠状动脉造影术（NYHA分级≥II）的患者（n=4951）。排除原发性瓣膜病或先天性心脏病患者。考克斯比例风险模型被用来评估冠状动脉疾病的严重程度之间的关系（定义为数量的病变血管）和血红蛋白concentration.Results和conclusionsIn患者有症状的HF进行冠状动脉造影，我们发现血红蛋白和CAD严重程度之间的相互作用（p=0.003的相互作用）。与我们的假设相反，与贫血相关的死亡风险在无CAD的患者中最大，并且随着CAD严重程度的增加而逐渐降低。这些数据表明，贫血可能通过不仅仅是心肌缺血恶化的机制对HF结局产生影响。
BackgroundAnaemia is common in heart failure (HF) and associated with higher mortality. Exacerbation of myocardial ischemia in patients with heart failure, coronary disease, and anaemia patients has been suggested as a potential mechanism underlying this association.AimsThe aim of this study was to evaluate the hypothesis that greater CAD severity would exacerbate the adverse effects of anaemia in HF.MethodsWe examined data on patients with symptomatic heart failure (NYHA class ≥II) undergoing coronary angiography between 1995 and 2003 (n=4951). Patients with primary valvular or congenital heart disease were excluded. Cox proportional hazards modeling was used to evaluate the relationship between coronary disease severity (as defined by no. of diseased vessels) and hemoglobin concentration.Results and conclusionsIn patients with symptomatic HF undergoing coronary angiography, we found an interaction between hemoglobin and CAD severity (p=0.003 for interaction). Contrary to our hypothesis, the mortality hazard associated with anaemia was greatest in patients without CAD and progressively lower with increasing CAD severity. These data suggest that anaemia may exert its effect on HF outcomes through mechanisms beyond simply the exacerbation of myocardial ischemia.