title: Heyde syndrome revisited: anaemia and aortic stenosis.
abstract: BACKGROUND
  The association of anaemia with aortic stenosis (AS) has been recognised for over 50 years; however, although there have been several sporadic reports, there are few data on the prevalence of this syndrome.
  
  
  OBJECTIVE
  We sought to compare the prevalence of anaemia in adults with AS with that of controls who had undergone coronary artery bypass grafting (CABG).
  
  
  METHODS
  We conducted a retrospective cohort study comparing pre-procedural levels of haemoglobin in 1537 adults who underwent aortic valve replacement (AVR) for AS with 8025 contemporaneous patients who had CABG. We hypothesised that the prevalence of anaemia in patients with AS would be significantly higher than in the control group.
  
  
  RESULTS
  A total of 30.1% in the AVR group was anaemic compared to 16.2% in the CABG group. The mean haemoglobin concentration measured across the whole population was significantly lower (132 g/L) in AVR patients than in those who underwent CABG (138 g/L). In a multivariable model, haemoglobin levels varied significantly by treatment group, gender and age. The adjusted marginal mean haemoglobin value was 135.6 g/L in AVR patients compared to 137.3 g/L in CABG patients.
  
  
  CONCLUSIONS
  The prevalence of anaemia was significantly greater in patients with AS than in a contemporaneous cohort that underwent CABG. This may indicate that Heyde syndrome is more common than has been generally appreciated and should be considered in the evaluation of anaemia in patients with AS.
authors.affiliation: Department of Cardiology, Prince Charles Hospital, Brisbane, Queensland, Australia.
authors.forename: Catherina
authors.initials: C
authors.lastname: Tjahjadi
authors.affiliation: Department of Cardiology, Prince Charles Hospital, Brisbane, Queensland, Australia.
authors.forename: Yong
authors.initials: Y
authors.lastname: Wee
authors.affiliation: Department of Statistics, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Hay
authors.affiliation: Department of Cardiac Surgery, Prince Charles Hospital, Brisbane, Queensland, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Tesar
authors.affiliation: Department of Cardiothoracic Surgery, Prince Charles Hospital, Brisbane, Queensland, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Clarke
authors.affiliation: Department of Cardiology, Prince Charles Hospital, Brisbane, Queensland, Australia.
authors.forename: Darren L
authors.initials: DL
authors.lastname: Walters
authors.affiliation: Department of Cardiology, Prince Charles Hospital, Brisbane, Queensland, Australia.
authors.forename: Nicholas
authors.identifier: http://orcid.org/0000-0001-8841-8310
authors.initials: N
authors.lastname: Bett
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D001024:Aortic Valve Stenosis / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000639:trends; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013577:Syndrome; D055815:Young Adult
keywords: anaemia; aortic valve stenosis; coronary artery bypass; haemoglobin