title: Hemoconcentration is a good prognostic predictor for clinical outcomes in acute heart failure: data from the Korean Heart Failure (KorHF) Registry.
abstract: BACKGROUND
  Hemoconcentration is a surrogate marker of effective decongestion and diuresis therapy. Recently, hemoconcentration has been associated with decreased mortality and rehospitalization in heart failure (HF) patients. However, the prognostic power of hemoconcentration in a large sample-sized HF cohort was limited until now.
  
  
  RESULTS
  We analyzed data from hospitalized patients with acute heart failure (AHF) that were enrolled in the Korean Heart Failure Registry(n=2,357). The primary end point was a composite of all-cause mortality and HF rehospitalization during the follow-up period (median=347, interquartile range=78-744 days).Hemoconcentration, defined as an increased hemoglobin level between admission and discharge, was presented in 1,016 AHF patients (43.1%). In multivariable logistic regression, hemoglobin, total cholesterol, and serum glucose levels at admission, and ischemic HF, were significant determinants for hemoconcentration occurrence. The Kaplan-Meier curve showed that event-free survival was significantly higher in the hemoconcentration group compared to the non-hemoconcentration group (65.1% vs. 58.1%, log rank p<0.001). In multiple Cox proportional hazard analysis, hemoconcentration was an independent predictor of the primary end point after adjusting for other HF risk factors (hazard ratio=0.671, 95% confidence interval=0.564-0.798, p<0.001).
  
  
  CONCLUSIONS
  Hemoconcentration during hospitalization was a prognostic marker of fewer clinical events in the AHF cohort. Therefore, this novel surrogate marker will help in the risk stratification of AHF patients.
authors: Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Seoul, Korea.
authors: Jaewon
authors: J
authors: Oh
authors: Seok-Min
authors: SM
authors: Kang
authors: Namki
authors: N
authors: Hong
authors: Jong-Chan
authors: JC
authors: Youn
authors: Seongwoo
authors: S
authors: Han
authors: Eun-Seok
authors: ES
authors: Jeon
authors: Myeong-Chan
authors: MC
authors: Cho
authors: Jae-Joong
authors: JJ
authors: Kim
authors: Byung-Su
authors: BS
authors: Yoo
authors: Shung Chull
authors: SC
authors: Chae
authors: Byung-Hee
authors: BH
authors: Oh
authors: Dong-Ju
authors: DJ
authors: Choi
authors: Myung-Mook
authors: MM
authors: Lee
authors: Kyu-Hyung
authors: KH
authors: Ryu
mesh_terms: D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002423:Cause of Death / Q000639:trends; D004232:Diuretics / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000188:drug therapy / Q000401:mortality; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D010359:Patient Readmission / Q000639:trends; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
chemical_list: D015415:Biomarkers; D004232:Diuretics; D006454:Hemoglobins
keywords: Acute heart failure; Hemoconcentration; Prognosis