Abstract 16838: Relative Hypochromia is Associated With Increased All-Cause Mortality in Non-Anemic Heart Failure Patients
Introduction: Anemia has been associated with increased mortality in heart failure patients, yet recent studies have suggested that functional iron deficiency may be contributing. However, the impact of a reduction of hemoglobin content in the erythrocytes as estimated by mean corpuscular hemoglobin concentration (MCHC) to long-term clinical outcomes has not been well-established.
Methods: We prospectively enrolled 1445 subjects with heart failure undergoing coronary angiography, with 5-year follow-up. Hemoglobin (Hb) and hematocrit were measured to calculate MHCH. Anemia was defined by Hb (<12 g/d in men, <11 g/dl in women). Cox proportional hazard survival analyses were performed with models further adjusted for age, BMI, sex, smoking, diabetes, hypertension, hyperlipidemia, history of CAD and medications (ACE inhibitors, Beta-Blockers, Statins and Aspirin).
Results: In our study cohort (mean age 66.3 ±1.1 years, 64% male, 38%diabetes, 75% ischemic), mean Hb and median MCHC were 12.5±1.6 g/dl and 34.2 (IQR 33.5 - 34.9) g/dl, respectively. 73% of the patients (1,059) have normal Hb levels. Patients with lower MCHC have higher mortality risk (Q4 vs Q1 adjusted Hazard ratio [HR] 2.1, 95%CI 1.56-2.83, p<0.001), even after further adjusting for Hb levels and MCV, or among non-anemic subjects (1,059 or 73%, HR, 2.1, 95%CI 1.5 - 2.9, p<0.001).
Conclusion: Relative hypochromia is an independent predictor of increase mortality in heart failure patients with normal hemoglobin levels
- © 2013 by American Heart Association, Inc.