Document Type
Article
Publication Date
4-15-2016
Publication Title
Journal of Vascular and Interventional Radiology
Abstract
The purpose of this study is to investigate the impact of a reduction of hemoglobin (Hb) content in the erythrocytes as estimated by mean corpuscular hemoglobin concentration (MCHC) on long-term clinical outcomes in nonanemic patients with heart failure (HF). We prospectively enrolled 1,579 subjects with HF who underwent coronary angiography enrolled in the GeneBank study with 5-year follow-up of all-cause mortality. Levels of Hb and MCHC were assessed at enrollment and after 6 months of follow-up. Anemia was defined as Hb levels <13 g/dl in men and <12 g/dl in women. In our nonanemic cohort (n = 785, 49.7%), mean Hb and median MCHC were 13.8 ± 1.1 g/dl and 34.3 g/dL (interquartile range 33.6 to 35), respectively. Nonanemic patients with heart failure with lower MCHC had higher mortality risk (quartiles 1 vs 4, hazard ratio = 2.1, 95% confidence interval 1.4 to 3.3, p = 0.001). In a subset of nonanemic patients with persistent normal Hb on follow-up (n = 206), the mean time between baseline and follow-up MCHC levels was 169.3 ± 41.6 days. In comparison with patients with levels of MCHC more than the first quartile (≥33.6 g/dl) on baseline and follow-up, patients with persistently low MCHC (<33.6 g/dl) had a significantly increased mortality risk (log rank <0.001). All models remained significant even after adjusting for traditional cardiac risk factors, left ventricular ejection fraction, baseline Hb levels, and mean corpuscular volume. In conclusion, relative hypochromia is an independent predictor of increased mortality risk in patients with HF, even in the setting of normal Hb levels.
Repository Citation
Hammadah, Muhammad; Brennan, Marie Luise; Wu, Yuping; Hazen, Stanley L.; and Tang, W.H. Wilson, "Usefulness of Relative Hypochromia in Risk Stratification for Nonanemic Patients With Chronic Heart Failure" (2016). Mathematics and Statistics Faculty Publications. 247.
https://engagedscholarship.csuohio.edu/scimath_facpub/247
DOI
10.1016/j.amjcard.2016.01.023
Version
Postprint
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Volume
117
Issue
8
Comments
This research was supported by grants R01HL103931 , P01HL076491 , and P01HL098055 from the National Institutes of Health, Bethesda, MD. Clinical samples used in this study were from the Cleveland Clinic GeneBank, a study supported by the National Institutes of Health grants R01HL103866 and P20HL113452 (with the Office of Dietary Supplements), and the Cleveland Clinic Clinical Research Unit of the Case Western Reserve University CTSA ( UL1TR 000439 ), Cleveland, OH.