title: [Chronic anemia in heart transplant patients: prevalence, predisposing factors and prognostic significance].
abstract: OBJECTIVE
  Data on chronic anemia following heart transplantation (HT) are scarce and contradictory. Our aims were to determine the prevalence of chronic anemia after HT, to identify predisposing factors for the condition at 12 months, and to evaluate its influence on medium-term and long-term survival.
  
  
  METHODS
  Retrospective analysis of patients who underwent HT between 1991 and 2005 (n=457). Chronic anemia was defined as a hemoglobin level <12 g/dL.
  
  
  RESULTS
  The prevalence of post-HT chronic anemia was 75.5% at 1 month, 31% at 12 months, and 26.2% at 120 months. The condition was significantly more prevalent among women than men. Predisposing factors for chronic anemia 1 year post-HT were mild-to-moderate chronic renal failure (i.e., creatinine level >1.5 mg/dL; odds ratio [OR]=2.8; 95% confidence interval [CI], 1.5-5.0), female sex (OR=6.4; 95% CI, 3.1-13.2), and immunosuppression with mycophenolate mofetil compared with azathioprine (OR=2.6;, 95% CI, 1.4-4.8). The prevalence of chronic anemia 12 months after HT was independent of the donor's sex, the recipient's age, the etiology of the recipient's heart failure, diabetes mellitus, mild-to-moderate graft rejection, cytomegalovirus infection, and angiotensin-converting enzyme inhibitor treatment. The presence of chronic anemia 12 months after HT did not influence either long-term survival (mean, 11.5 years with chronic anemia vs. 13.0 years without) or actuarial survival.
  
  
  CONCLUSIONS
  Post-HT chronic anemia is common, but improves with time and treatment. Predisposing factors for the condition 1 year post-HT include chronic renal failure, female sex, and immunosuppression with mycophenolate mofetil. The presence of chronic anemia does not appear to influence long-term survival.
authors.affiliation: Area del Corazón. Complejo Hospitalario Universitario Juan Canalejo, A Coruña, España.
authors.forename: Guillermo C
authors.initials: GC
authors.lastname: Cursack
authors.forename: María G
authors.initials: MG
authors.lastname: Crespo-Leiro
authors.forename: María J
authors.initials: MJ
authors.lastname: Paniagua-Martín
authors.forename: Javier
authors.initials: J
authors.lastname: Muñiz
authors.forename: Carmen
authors.initials: C
authors.lastname: Naya
authors.forename: Zulaika
authors.initials: Z
authors.lastname: Grille
authors.forename: José A
authors.initials: JA
authors.lastname: Rodríguez
authors.forename: Raquel
authors.initials: R
authors.lastname: Marzoa
authors.forename: Eduardo
authors.initials: E
authors.lastname: Barge
authors.forename: Ramón
authors.initials: R
authors.lastname: Ríos
authors.forename: Francisco
authors.initials: F
authors.lastname: Estévez
authors.forename: José J
authors.initials: JJ
authors.lastname: Cuenca
authors.forename: Alberto
authors.initials: A
authors.lastname: Juffé-Stein
authors.forename: Alfonso
authors.initials: A
authors.lastname: Castro-Beiras
mesh_terms: D000740:Anemia / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D015984:Causality; D002908:Chronic Disease; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors