Significance of anaemia in patients with advanced heart failure receiving long-term mechanical circulatory support.
OBJECTIVE
The aim of this study was to analyse the prognostic impact of anaemia in patients receiving long-term left ventricular assist device (LVAD) support.


RESULTS
We reviewed the data of 65 consecutive patients who underwent LVAD support for at least 6 months. Anaemia was defined as haemoglobin levels <12.0 g/dL. Follow-up was performed 15 months after implantation. Anaemia was present in 30/65 patients (46%) after 6 months of LVAD support. Anaemic patients had higher levels of pre-implant creatinine (1.8 +/- 0.8 vs. 1.4 +/- 0.5 mg/dL; P = 0.04). The presence of anaemia after 6 months correlated with higher levels of creatinine and blood urea nitrogen and lower levels of albumin. Multivariate Cox proportional hazards regression analysis revealed that levels of haemoglobin <12 g/dL [risk ratio (RR), 8.94; 95% confidence interval (CI), 1.09-73.01; P = 0.04], creatinine >1.4 mg/dL (RR, 5.39; 95% CI, 1.78-16.30; P = 0.003), and albumin <1.5 g/L (RR, 3.23; 95% CI, 1.10-9.51; P = 0.03) were associated with all-cause mortality at 15 months. Long-term survival evaluated by Kaplan-Meier analysis was two times higher in non-anaemic patients after 6 months of LVAD support than in anaemic patients (P = 0.01).


CONCLUSIONS
Anaemia is related to adverse outcomes in patients receiving prolonged LVAD support.
Vrtovec
Bojan
B
Center for Cardiac Support, Texas Heart Institute at St Luke's Episcopal Hospital, Houston, TX 77225-0345, USA.
Radovancevic
Rajko
R
Delgado
Reynolds M
RM
Radovancevic
Branislav
B
Bracey
Arthur W
AW
Gregoric
Igor D
ID
Frazier
O H
OH
D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D000740:Anemia / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D001774:Blood Chemical Analysis; D015331:Cohort Studies; D004921:Erythropoietin / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011336:Probability; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D016019:Survival Analysis; D013997:Time Factors
D004921:Erythropoietin