title: Prognostic Impact of Anemia in Patients With Chronic Heart Failure- With Special Reference to Clinical Background: Report From the CHART-2 Study.
abstract: BACKGROUND
  We aimed to elucidate the prognostic impact of anemia with special reference to the clinical background of patients with chronic heart failure (CHF).
  
  
  RESULTS
  We examined 4,646 consecutive patients with Stage C/D CHF registered in the Chronic Heart Failure Analysis and Registry in the Tohoku District-2 (CHART-2) Study (n=10,219). Among them, 1,627 (35%) had anemia and were characterized by higher age (74 vs. 66 years), lower estimated glomerular filtration rate (52.8 vs. 66.1 ml/min/1.73 m(2)) and higher B-type natriuretic peptide levels (154.5 vs. 81.8 pg/ml) (all P<0.001) but comparable left ventricular ejection fraction (LVEF; 57.5 vs. 56.7%). Anemic patients were more frequently treated with diuretics (55.1 vs. 42.3%) but less often treated with β-blockers (45.4 vs. 51.1%) (both P<0.001). During a median follow-up of 3.8 years, 371 and 272 patients died with and without anemia, respectively (22.8 vs. 9.0%, adjusted hazard ratio 1.40; 95% confidence interval 1.15-1.71, P=0.001). Subgroup analysis revealed that the prognostic impact of anemia was comparable in terms of age, sex, renal function and double product, but differed by LVEF level and CHF etiology (both, P for interaction <0.001). In particular, a difference in the prognostic impact of LVEF level was noted in patients with ischemic heart disease.
  
  
  CONCLUSIONS
  These results indicate that the prognostic impact of anemia is evident in CHF patients with preserved EF and it differs by CHF etiology.
authors.affiliation: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamauchi
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sakata
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takada
authors.forename: Kotaro
authors.initials: K
authors.lastname: Nochioka
authors.forename: Masanobu
authors.initials: M
authors.lastname: Miura
authors.forename: Soichiro
authors.initials: S
authors.lastname: Tadaki
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Ushigome
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Sato
authors.forename: Takeo
authors.initials: T
authors.lastname: Onose
authors.forename: Kanako
authors.initials: K
authors.lastname: Tsuji
authors.forename: Ruri
authors.initials: R
authors.lastname: Abe
authors.forename: Jun
authors.initials: J
authors.lastname: Takahashi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Miyata
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimokawa
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood / Q000188:drug therapy / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D002908:Chronic Disease; D018572:Disease-Free Survival; D004232:Diuretics / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011446:Prospective Studies; D013318:Stroke Volume / Q000187:drug effects; D015996:Survival Rate
chemical_list: D000319:Adrenergic beta-Antagonists; D004232:Diuretics; D020097:Natriuretic Peptide, Brain