Prognostic significance of anaemia in patients with heart failure with preserved and reduced ejection fraction: Results from the MAGGIC individual patient data meta-analysis

C. Berry, K. K. Poppe, G. D. Gamble, N. J. Earle, J. A. Ezekowitz, I. B. Squire, J. J.V. McMurray, F. A. McAlister, M. Komajda, K. Swedberg, A. P. Maggioni, A. Ahmed, G. A. Whalley, R. N. Doughty, L. Tarantini, C. Granger, L. Køber, B. Massie, S. Pocock, J. SomaratneB. Andersson, A. Bayes-Genis, M. Cowie, R. Cubbon, J. Gonzalez-Juanatey, M. Gorini, I. Gotsman, L. Grigorian-Shamagian, M. Guazzi, M. Kearney, A. Di Lenarda, M. Lenzen, D. Lucci, S. Macín, B. Madsen, M. Martínez-Sellés, F. Oliva, M. Rich, M. Richards, M. Senni, G. Taffet, C. Tribouilloy, R. Troughton, H. Tsutsui, C. Ariti, J. Dobson, C. Hall, J. Lainchbury, K. Hogg, J. Norrie, K. Stevenson, M. Brett, M. A. Pfeffer, P. Held, E. L. Michelson, B. Olofsson, J. Östergren, S. Yusuf, C. Torp-Pedersen, W. Scholte op Reimer, E. Boersma, P. J.M.J. Vantrimpont, F. Follath, J. Cleland, D. Zwas, D. Planer, T. Azaz-Livshits, D. Admon, C. Lotan, A. Keren, A. Varela-Roman, P. Mazón-Ramos, P. Rigeiro-Veloso, M. A. Bandin-Dieguez, J. Myers, R. Arena, P. W. Armstrong, Bibiana Cujec, Ian Paterson, D. A. Wood, A. J.S. Coats, S. G. Thompson, V. Suresh, P. A. Poole-Wilson, G. C. Sutton, J. A.G. Robles, L. Prieto, M. D. Muñoa, E. Frades, O. Díaz-Castro, J. Almendral, P. Faggiano, D. Bertoli, M. Porcu, C. Opasich, L. Tavazzi, V. Kirk, M. Bay, J. Parner, K. Krogsgaard, T. M. Herzog, S. Boesgaard, C. Hassager, O. W. Nielsen, J. Aldershvile, H. Nielsen, L. Kober, E. R. Perna, J. P. Cimbaro Canella, P. Alvarenga, R. Pantich, N. Ríos, E. F. Farias, J. R. Badaracco, J. F. Hansen, K. H. Stokholm, J. Brons, D. Husum, L. S. Mortensen, R. Vazquez, T. Puig, C. Fernandez-Palomeque, A. Bardají, D. Pascual-Figal, J. Ordoñez-Llanos, M. Valdes, A. Gabarrus, R. Pavon, L. Pastor, M. Fiol, V. Nieto, C. Macaya, J. Cinca, I. Cygankiewitz, A. Bayes De Luna, J. D. Newton, H. M. Blackledge, S. P. Wright, R. Kerzner, B. F. Gage, K. E. Freedland, B. C. Huynh, A. Rovner, R. M. Carney, T. A. Teasdale, A. J. Bleyer, N. J. Kutka, R. J. Luchi, D. Rusinaru, H. Mahjoub, V. Soulière, F. Lévy, M. Peltier, M. Tsuchihashi, A. Takeshita, P. A. MacCarthy, J. Nolan, A. J. Lee, R. J. Prescott, A. M. Shah, W. P. Brooksby, K. A.A. Fox, P. Basante, R. Trillo, J. Garcia-Seara, J. L. Martinez-Sande, F. Gude

Research output: Contribution to journalArticle

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Abstract

Background: Anaemia is common among patients with heart failure (HF) and is an important prognostic marker. Aim: We sought to determine the prognostic importance of anaemia in a large multinational pooled dataset of prospectively enrolled HF patients, with the specific aim to determine the prognostic role of anaemia in HF with preserved and reduced ejection fraction (HF-PEF and HF-REF, respectively). Design: Individual person data meta-analysis. Methods: Patients with haemoglobin (Hb) data fromthe MAGGIC dataset were used. Anaemia was defined as Hb < 120 g/l in women and <130 g/l inmen. HF-PEF was defined as EF ≥ 50%; HF-REF was EF < 50%. Cox proportional hazardmodelling, with adjustment for clinically relevant variables, was undertaken to investigate factors associated with 3-year all-causemortality. Results: Thirteen thousand two hundred and ninety-five patients with HF from 19 studies (9887 with HF-REF and 3408 with HF-PEF). The prevalence of anaemia was similar among those with HF-REF and HF-PEF (42.8 and 41.6% respectively). Compared with patients with normal Hb values, those with anaemia were older, were more likely to have diabetes, ischaemic aetiology, New York Heart Association class IV symptoms, lower estimated glomerular filtration rate and were more likely to be taking diuretic and less likely to be taking a beta-blocker. Patients with anaemia had higher all-cause mortality (adjusted hazard ratio [aHR] 1.38, 95% confidence interval [CI] 1.25-1.51), independent of EF group: aHR 1.67 (1.39-1.99) in HFPEF and aHR 2.49 (2.13-2.90) in HF-REF. Conclusions: Anaemia is an adverse prognostic factor in HF irrespective of EF. The prognostic importance of anaemia was greatest in patients with HF-REF.

Original languageEnglish
Pages (from-to)377-382
Number of pages6
JournalQJM
Volume109
Issue number6
DOIs
Publication statusPublished - Jan 1 2016

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Meta-Analysis
Anemia
Heart Failure
Hemoglobins
Glomerular Filtration Rate
Diuretics
Reference Values
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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Prognostic significance of anaemia in patients with heart failure with preserved and reduced ejection fraction : Results from the MAGGIC individual patient data meta-analysis. / Berry, C.; Poppe, K. K.; Gamble, G. D.; Earle, N. J.; Ezekowitz, J. A.; Squire, I. B.; McMurray, J. J.V.; McAlister, F. A.; Komajda, M.; Swedberg, K.; Maggioni, A. P.; Ahmed, A.; Whalley, G. A.; Doughty, R. N.; Tarantini, L.; Granger, C.; Køber, L.; Massie, B.; Pocock, S.; Somaratne, J.; Andersson, B.; Bayes-Genis, A.; Cowie, M.; Cubbon, R.; Gonzalez-Juanatey, J.; Gorini, M.; Gotsman, I.; Grigorian-Shamagian, L.; Guazzi, M.; Kearney, M.; Di Lenarda, A.; Lenzen, M.; Lucci, D.; Macín, S.; Madsen, B.; Martínez-Sellés, M.; Oliva, F.; Rich, M.; Richards, M.; Senni, M.; Taffet, G.; Tribouilloy, C.; Troughton, R.; Tsutsui, H.; Ariti, C.; Dobson, J.; Hall, C.; Lainchbury, J.; Hogg, K.; Norrie, J.; Stevenson, K.; Brett, M.; Pfeffer, M. A.; Held, P.; Michelson, E. L.; Olofsson, B.; Östergren, J.; Yusuf, S.; Torp-Pedersen, C.; Scholte op Reimer, W.; Boersma, E.; Vantrimpont, P. J.M.J.; Follath, F.; Cleland, J.; Zwas, D.; Planer, D.; Azaz-Livshits, T.; Admon, D.; Lotan, C.; Keren, A.; Varela-Roman, A.; Mazón-Ramos, P.; Rigeiro-Veloso, P.; Bandin-Dieguez, M. A.; Myers, J.; Arena, R.; Armstrong, P. W.; Cujec, Bibiana; Paterson, Ian; Wood, D. A.; Coats, A. J.S.; Thompson, S. G.; Suresh, V.; Poole-Wilson, P. A.; Sutton, G. C.; Robles, J. A.G.; Prieto, L.; Muñoa, M. D.; Frades, E.; Díaz-Castro, O.; Almendral, J.; Faggiano, P.; Bertoli, D.; Porcu, M.; Opasich, C.; Tavazzi, L.; Kirk, V.; Bay, M.; Parner, J.; Krogsgaard, K.; Herzog, T. M.; Boesgaard, S.; Hassager, C.; Nielsen, O. W.; Aldershvile, J.; Nielsen, H.; Kober, L.; Perna, E. R.; Cimbaro Canella, J. P.; Alvarenga, P.; Pantich, R.; Ríos, N.; Farias, E. F.; Badaracco, J. R.; Hansen, J. F.; Stokholm, K. H.; Brons, J.; Husum, D.; Mortensen, L. S.; Vazquez, R.; Puig, T.; Fernandez-Palomeque, C.; Bardají, A.; Pascual-Figal, D.; Ordoñez-Llanos, J.; Valdes, M.; Gabarrus, A.; Pavon, R.; Pastor, L.; Fiol, M.; Nieto, V.; Macaya, C.; Cinca, J.; Cygankiewitz, I.; Bayes De Luna, A.; Newton, J. D.; Blackledge, H. M.; Wright, S. P.; Kerzner, R.; Gage, B. F.; Freedland, K. E.; Huynh, B. C.; Rovner, A.; Carney, R. M.; Teasdale, T. A.; Bleyer, A. J.; Kutka, N. J.; Luchi, R. J.; Rusinaru, D.; Mahjoub, H.; Soulière, V.; Lévy, F.; Peltier, M.; Tsuchihashi, M.; Takeshita, A.; MacCarthy, P. A.; Nolan, J.; Lee, A. J.; Prescott, R. J.; Shah, A. M.; Brooksby, W. P.; Fox, K. A.A.; Basante, P.; Trillo, R.; Garcia-Seara, J.; Martinez-Sande, J. L.; Gude, F.

In: QJM, Vol. 109, No. 6, 01.01.2016, p. 377-382.

Research output: Contribution to journalArticle

Berry, C, Poppe, KK, Gamble, GD, Earle, NJ, Ezekowitz, JA, Squire, IB, McMurray, JJV, McAlister, FA, Komajda, M, Swedberg, K, Maggioni, AP, Ahmed, A, Whalley, GA, Doughty, RN, Tarantini, L, Granger, C, Køber, L, Massie, B, Pocock, S, Somaratne, J, Andersson, B, Bayes-Genis, A, Cowie, M, Cubbon, R, Gonzalez-Juanatey, J, Gorini, M, Gotsman, I, Grigorian-Shamagian, L, Guazzi, M, Kearney, M, Di Lenarda, A, Lenzen, M, Lucci, D, Macín, S, Madsen, B, Martínez-Sellés, M, Oliva, F, Rich, M, Richards, M, Senni, M, Taffet, G, Tribouilloy, C, Troughton, R, Tsutsui, H, Ariti, C, Dobson, J, Hall, C, Lainchbury, J, Hogg, K, Norrie, J, Stevenson, K, Brett, M, Pfeffer, MA, Held, P, Michelson, EL, Olofsson, B, Östergren, J, Yusuf, S, Torp-Pedersen, C, Scholte op Reimer, W, Boersma, E, Vantrimpont, PJMJ, Follath, F, Cleland, J, Zwas, D, Planer, D, Azaz-Livshits, T, Admon, D, Lotan, C, Keren, A, Varela-Roman, A, Mazón-Ramos, P, Rigeiro-Veloso, P, Bandin-Dieguez, MA, Myers, J, Arena, R, Armstrong, PW, Cujec, B, Paterson, I, Wood, DA, Coats, AJS, Thompson, SG, Suresh, V, Poole-Wilson, PA, Sutton, GC, Robles, JAG, Prieto, L, Muñoa, MD, Frades, E, Díaz-Castro, O, Almendral, J, Faggiano, P, Bertoli, D, Porcu, M, Opasich, C, Tavazzi, L, Kirk, V, Bay, M, Parner, J, Krogsgaard, K, Herzog, TM, Boesgaard, S, Hassager, C, Nielsen, OW, Aldershvile, J, Nielsen, H, Kober, L, Perna, ER, Cimbaro Canella, JP, Alvarenga, P, Pantich, R, Ríos, N, Farias, EF, Badaracco, JR, Hansen, JF, Stokholm, KH, Brons, J, Husum, D, Mortensen, LS, Vazquez, R, Puig, T, Fernandez-Palomeque, C, Bardají, A, Pascual-Figal, D, Ordoñez-Llanos, J, Valdes, M, Gabarrus, A, Pavon, R, Pastor, L, Fiol, M, Nieto, V, Macaya, C, Cinca, J, Cygankiewitz, I, Bayes De Luna, A, Newton, JD, Blackledge, HM, Wright, SP, Kerzner, R, Gage, BF, Freedland, KE, Huynh, BC, Rovner, A, Carney, RM, Teasdale, TA, Bleyer, AJ, Kutka, NJ, Luchi, RJ, Rusinaru, D, Mahjoub, H, Soulière, V, Lévy, F, Peltier, M, Tsuchihashi, M, Takeshita, A, MacCarthy, PA, Nolan, J, Lee, AJ, Prescott, RJ, Shah, AM, Brooksby, WP, Fox, KAA, Basante, P, Trillo, R, Garcia-Seara, J, Martinez-Sande, JL & Gude, F 2016, 'Prognostic significance of anaemia in patients with heart failure with preserved and reduced ejection fraction: Results from the MAGGIC individual patient data meta-analysis', QJM, vol. 109, no. 6, pp. 377-382. https://doi.org/10.1093/qjmed/hcv087
Berry, C. ; Poppe, K. K. ; Gamble, G. D. ; Earle, N. J. ; Ezekowitz, J. A. ; Squire, I. B. ; McMurray, J. J.V. ; McAlister, F. A. ; Komajda, M. ; Swedberg, K. ; Maggioni, A. P. ; Ahmed, A. ; Whalley, G. A. ; Doughty, R. N. ; Tarantini, L. ; Granger, C. ; Køber, L. ; Massie, B. ; Pocock, S. ; Somaratne, J. ; Andersson, B. ; Bayes-Genis, A. ; Cowie, M. ; Cubbon, R. ; Gonzalez-Juanatey, J. ; Gorini, M. ; Gotsman, I. ; Grigorian-Shamagian, L. ; Guazzi, M. ; Kearney, M. ; Di Lenarda, A. ; Lenzen, M. ; Lucci, D. ; Macín, S. ; Madsen, B. ; Martínez-Sellés, M. ; Oliva, F. ; Rich, M. ; Richards, M. ; Senni, M. ; Taffet, G. ; Tribouilloy, C. ; Troughton, R. ; Tsutsui, H. ; Ariti, C. ; Dobson, J. ; Hall, C. ; Lainchbury, J. ; Hogg, K. ; Norrie, J. ; Stevenson, K. ; Brett, M. ; Pfeffer, M. A. ; Held, P. ; Michelson, E. L. ; Olofsson, B. ; Östergren, J. ; Yusuf, S. ; Torp-Pedersen, C. ; Scholte op Reimer, W. ; Boersma, E. ; Vantrimpont, P. J.M.J. ; Follath, F. ; Cleland, J. ; Zwas, D. ; Planer, D. ; Azaz-Livshits, T. ; Admon, D. ; Lotan, C. ; Keren, A. ; Varela-Roman, A. ; Mazón-Ramos, P. ; Rigeiro-Veloso, P. ; Bandin-Dieguez, M. A. ; Myers, J. ; Arena, R. ; Armstrong, P. W. ; Cujec, Bibiana ; Paterson, Ian ; Wood, D. A. ; Coats, A. J.S. ; Thompson, S. G. ; Suresh, V. ; Poole-Wilson, P. A. ; Sutton, G. C. ; Robles, J. A.G. ; Prieto, L. ; Muñoa, M. D. ; Frades, E. ; Díaz-Castro, O. ; Almendral, J. ; Faggiano, P. ; Bertoli, D. ; Porcu, M. ; Opasich, C. ; Tavazzi, L. ; Kirk, V. ; Bay, M. ; Parner, J. ; Krogsgaard, K. ; Herzog, T. M. ; Boesgaard, S. ; Hassager, C. ; Nielsen, O. W. ; Aldershvile, J. ; Nielsen, H. ; Kober, L. ; Perna, E. R. ; Cimbaro Canella, J. P. ; Alvarenga, P. ; Pantich, R. ; Ríos, N. ; Farias, E. F. ; Badaracco, J. R. ; Hansen, J. F. ; Stokholm, K. H. ; Brons, J. ; Husum, D. ; Mortensen, L. S. ; Vazquez, R. ; Puig, T. ; Fernandez-Palomeque, C. ; Bardají, A. ; Pascual-Figal, D. ; Ordoñez-Llanos, J. ; Valdes, M. ; Gabarrus, A. ; Pavon, R. ; Pastor, L. ; Fiol, M. ; Nieto, V. ; Macaya, C. ; Cinca, J. ; Cygankiewitz, I. ; Bayes De Luna, A. ; Newton, J. D. ; Blackledge, H. M. ; Wright, S. P. ; Kerzner, R. ; Gage, B. F. ; Freedland, K. E. ; Huynh, B. C. ; Rovner, A. ; Carney, R. M. ; Teasdale, T. A. ; Bleyer, A. J. ; Kutka, N. J. ; Luchi, R. J. ; Rusinaru, D. ; Mahjoub, H. ; Soulière, V. ; Lévy, F. ; Peltier, M. ; Tsuchihashi, M. ; Takeshita, A. ; MacCarthy, P. A. ; Nolan, J. ; Lee, A. J. ; Prescott, R. J. ; Shah, A. M. ; Brooksby, W. P. ; Fox, K. A.A. ; Basante, P. ; Trillo, R. ; Garcia-Seara, J. ; Martinez-Sande, J. L. ; Gude, F. / Prognostic significance of anaemia in patients with heart failure with preserved and reduced ejection fraction : Results from the MAGGIC individual patient data meta-analysis. In: QJM. 2016 ; Vol. 109, No. 6. pp. 377-382.
@article{3bfed2fcd67d420e9d5261c36184d0f6,
title = "Prognostic significance of anaemia in patients with heart failure with preserved and reduced ejection fraction: Results from the MAGGIC individual patient data meta-analysis",
abstract = "Background: Anaemia is common among patients with heart failure (HF) and is an important prognostic marker. Aim: We sought to determine the prognostic importance of anaemia in a large multinational pooled dataset of prospectively enrolled HF patients, with the specific aim to determine the prognostic role of anaemia in HF with preserved and reduced ejection fraction (HF-PEF and HF-REF, respectively). Design: Individual person data meta-analysis. Methods: Patients with haemoglobin (Hb) data fromthe MAGGIC dataset were used. Anaemia was defined as Hb < 120 g/l in women and <130 g/l inmen. HF-PEF was defined as EF ≥ 50{\%}; HF-REF was EF < 50{\%}. Cox proportional hazardmodelling, with adjustment for clinically relevant variables, was undertaken to investigate factors associated with 3-year all-causemortality. Results: Thirteen thousand two hundred and ninety-five patients with HF from 19 studies (9887 with HF-REF and 3408 with HF-PEF). The prevalence of anaemia was similar among those with HF-REF and HF-PEF (42.8 and 41.6{\%} respectively). Compared with patients with normal Hb values, those with anaemia were older, were more likely to have diabetes, ischaemic aetiology, New York Heart Association class IV symptoms, lower estimated glomerular filtration rate and were more likely to be taking diuretic and less likely to be taking a beta-blocker. Patients with anaemia had higher all-cause mortality (adjusted hazard ratio [aHR] 1.38, 95{\%} confidence interval [CI] 1.25-1.51), independent of EF group: aHR 1.67 (1.39-1.99) in HFPEF and aHR 2.49 (2.13-2.90) in HF-REF. Conclusions: Anaemia is an adverse prognostic factor in HF irrespective of EF. The prognostic importance of anaemia was greatest in patients with HF-REF.",
author = "C. Berry and Poppe, {K. K.} and Gamble, {G. D.} and Earle, {N. J.} and Ezekowitz, {J. A.} and Squire, {I. B.} and McMurray, {J. J.V.} and McAlister, {F. A.} and M. Komajda and K. Swedberg and Maggioni, {A. P.} and A. Ahmed and Whalley, {G. A.} and Doughty, {R. N.} and L. Tarantini and C. Granger and L. K{\o}ber and B. Massie and S. Pocock and J. Somaratne and B. Andersson and A. Bayes-Genis and M. Cowie and R. Cubbon and J. Gonzalez-Juanatey and M. Gorini and I. Gotsman and L. Grigorian-Shamagian and M. Guazzi and M. Kearney and {Di Lenarda}, A. and M. Lenzen and D. Lucci and S. Mac{\'i}n and B. Madsen and M. Mart{\'i}nez-Sell{\'e}s and F. Oliva and M. Rich and M. Richards and M. Senni and G. Taffet and C. Tribouilloy and R. Troughton and H. Tsutsui and C. Ariti and J. Dobson and C. Hall and J. Lainchbury and K. Hogg and J. Norrie and K. Stevenson and M. Brett and Pfeffer, {M. A.} and P. Held and Michelson, {E. L.} and B. Olofsson and J. {\"O}stergren and S. Yusuf and C. Torp-Pedersen and {Scholte op Reimer}, W. and E. Boersma and Vantrimpont, {P. J.M.J.} and F. Follath and J. Cleland and D. Zwas and D. Planer and T. Azaz-Livshits and D. Admon and C. Lotan and A. Keren and A. Varela-Roman and P. Maz{\'o}n-Ramos and P. Rigeiro-Veloso and Bandin-Dieguez, {M. A.} and J. Myers and R. Arena and Armstrong, {P. W.} and Bibiana Cujec and Ian Paterson and Wood, {D. A.} and Coats, {A. J.S.} and Thompson, {S. G.} and V. Suresh and Poole-Wilson, {P. A.} and Sutton, {G. C.} and Robles, {J. A.G.} and L. Prieto and Mu{\~n}oa, {M. D.} and E. Frades and O. D{\'i}az-Castro and J. Almendral and P. Faggiano and D. Bertoli and M. Porcu and C. Opasich and L. Tavazzi and V. Kirk and M. Bay and J. Parner and K. Krogsgaard and Herzog, {T. M.} and S. Boesgaard and C. Hassager and Nielsen, {O. W.} and J. Aldershvile and H. Nielsen and L. Kober and Perna, {E. R.} and {Cimbaro Canella}, {J. P.} and P. Alvarenga and R. Pantich and N. R{\'i}os and Farias, {E. F.} and Badaracco, {J. R.} and Hansen, {J. F.} and Stokholm, {K. H.} and J. Brons and D. Husum and Mortensen, {L. S.} and R. Vazquez and T. Puig and C. Fernandez-Palomeque and A. Bardaj{\'i} and D. Pascual-Figal and J. Ordo{\~n}ez-Llanos and M. Valdes and A. Gabarrus and R. Pavon and L. Pastor and M. Fiol and V. Nieto and C. Macaya and J. Cinca and I. Cygankiewitz and {Bayes De Luna}, A. and Newton, {J. D.} and Blackledge, {H. M.} and Wright, {S. P.} and R. Kerzner and Gage, {B. F.} and Freedland, {K. E.} and Huynh, {B. C.} and A. Rovner and Carney, {R. M.} and Teasdale, {T. A.} and Bleyer, {A. J.} and Kutka, {N. J.} and Luchi, {R. J.} and D. Rusinaru and H. Mahjoub and V. Souli{\`e}re and F. L{\'e}vy and M. Peltier and M. Tsuchihashi and A. Takeshita and MacCarthy, {P. A.} and J. Nolan and Lee, {A. J.} and Prescott, {R. J.} and Shah, {A. M.} and Brooksby, {W. P.} and Fox, {K. A.A.} and P. Basante and R. Trillo and J. Garcia-Seara and Martinez-Sande, {J. L.} and F. Gude",
year = "2016",
month = "1",
day = "1",
doi = "10.1093/qjmed/hcv087",
language = "English",
volume = "109",
pages = "377--382",
journal = "QJM - Monthly Journal of the Association of Physicians",
issn = "1460-2725",
publisher = "Oxford University Press",
number = "6",

}

TY - JOUR

T1 - Prognostic significance of anaemia in patients with heart failure with preserved and reduced ejection fraction

T2 - Results from the MAGGIC individual patient data meta-analysis

AU - Berry, C.

AU - Poppe, K. K.

AU - Gamble, G. D.

AU - Earle, N. J.

AU - Ezekowitz, J. A.

AU - Squire, I. B.

AU - McMurray, J. J.V.

AU - McAlister, F. A.

AU - Komajda, M.

AU - Swedberg, K.

AU - Maggioni, A. P.

AU - Ahmed, A.

AU - Whalley, G. A.

AU - Doughty, R. N.

AU - Tarantini, L.

AU - Granger, C.

AU - Køber, L.

AU - Massie, B.

AU - Pocock, S.

AU - Somaratne, J.

AU - Andersson, B.

AU - Bayes-Genis, A.

AU - Cowie, M.

AU - Cubbon, R.

AU - Gonzalez-Juanatey, J.

AU - Gorini, M.

AU - Gotsman, I.

AU - Grigorian-Shamagian, L.

AU - Guazzi, M.

AU - Kearney, M.

AU - Di Lenarda, A.

AU - Lenzen, M.

AU - Lucci, D.

AU - Macín, S.

AU - Madsen, B.

AU - Martínez-Sellés, M.

AU - Oliva, F.

AU - Rich, M.

AU - Richards, M.

AU - Senni, M.

AU - Taffet, G.

AU - Tribouilloy, C.

AU - Troughton, R.

AU - Tsutsui, H.

AU - Ariti, C.

AU - Dobson, J.

AU - Hall, C.

AU - Lainchbury, J.

AU - Hogg, K.

AU - Norrie, J.

AU - Stevenson, K.

AU - Brett, M.

AU - Pfeffer, M. A.

AU - Held, P.

AU - Michelson, E. L.

AU - Olofsson, B.

AU - Östergren, J.

AU - Yusuf, S.

AU - Torp-Pedersen, C.

AU - Scholte op Reimer, W.

AU - Boersma, E.

AU - Vantrimpont, P. J.M.J.

AU - Follath, F.

AU - Cleland, J.

AU - Zwas, D.

AU - Planer, D.

AU - Azaz-Livshits, T.

AU - Admon, D.

AU - Lotan, C.

AU - Keren, A.

AU - Varela-Roman, A.

AU - Mazón-Ramos, P.

AU - Rigeiro-Veloso, P.

AU - Bandin-Dieguez, M. A.

AU - Myers, J.

AU - Arena, R.

AU - Armstrong, P. W.

AU - Cujec, Bibiana

AU - Paterson, Ian

AU - Wood, D. A.

AU - Coats, A. J.S.

AU - Thompson, S. G.

AU - Suresh, V.

AU - Poole-Wilson, P. A.

AU - Sutton, G. C.

AU - Robles, J. A.G.

AU - Prieto, L.

AU - Muñoa, M. D.

AU - Frades, E.

AU - Díaz-Castro, O.

AU - Almendral, J.

AU - Faggiano, P.

AU - Bertoli, D.

AU - Porcu, M.

AU - Opasich, C.

AU - Tavazzi, L.

AU - Kirk, V.

AU - Bay, M.

AU - Parner, J.

AU - Krogsgaard, K.

AU - Herzog, T. M.

AU - Boesgaard, S.

AU - Hassager, C.

AU - Nielsen, O. W.

AU - Aldershvile, J.

AU - Nielsen, H.

AU - Kober, L.

AU - Perna, E. R.

AU - Cimbaro Canella, J. P.

AU - Alvarenga, P.

AU - Pantich, R.

AU - Ríos, N.

AU - Farias, E. F.

AU - Badaracco, J. R.

AU - Hansen, J. F.

AU - Stokholm, K. H.

AU - Brons, J.

AU - Husum, D.

AU - Mortensen, L. S.

AU - Vazquez, R.

AU - Puig, T.

AU - Fernandez-Palomeque, C.

AU - Bardají, A.

AU - Pascual-Figal, D.

AU - Ordoñez-Llanos, J.

AU - Valdes, M.

AU - Gabarrus, A.

AU - Pavon, R.

AU - Pastor, L.

AU - Fiol, M.

AU - Nieto, V.

AU - Macaya, C.

AU - Cinca, J.

AU - Cygankiewitz, I.

AU - Bayes De Luna, A.

AU - Newton, J. D.

AU - Blackledge, H. M.

AU - Wright, S. P.

AU - Kerzner, R.

AU - Gage, B. F.

AU - Freedland, K. E.

AU - Huynh, B. C.

AU - Rovner, A.

AU - Carney, R. M.

AU - Teasdale, T. A.

AU - Bleyer, A. J.

AU - Kutka, N. J.

AU - Luchi, R. J.

AU - Rusinaru, D.

AU - Mahjoub, H.

AU - Soulière, V.

AU - Lévy, F.

AU - Peltier, M.

AU - Tsuchihashi, M.

AU - Takeshita, A.

AU - MacCarthy, P. A.

AU - Nolan, J.

AU - Lee, A. J.

AU - Prescott, R. J.

AU - Shah, A. M.

AU - Brooksby, W. P.

AU - Fox, K. A.A.

AU - Basante, P.

AU - Trillo, R.

AU - Garcia-Seara, J.

AU - Martinez-Sande, J. L.

AU - Gude, F.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Background: Anaemia is common among patients with heart failure (HF) and is an important prognostic marker. Aim: We sought to determine the prognostic importance of anaemia in a large multinational pooled dataset of prospectively enrolled HF patients, with the specific aim to determine the prognostic role of anaemia in HF with preserved and reduced ejection fraction (HF-PEF and HF-REF, respectively). Design: Individual person data meta-analysis. Methods: Patients with haemoglobin (Hb) data fromthe MAGGIC dataset were used. Anaemia was defined as Hb < 120 g/l in women and <130 g/l inmen. HF-PEF was defined as EF ≥ 50%; HF-REF was EF < 50%. Cox proportional hazardmodelling, with adjustment for clinically relevant variables, was undertaken to investigate factors associated with 3-year all-causemortality. Results: Thirteen thousand two hundred and ninety-five patients with HF from 19 studies (9887 with HF-REF and 3408 with HF-PEF). The prevalence of anaemia was similar among those with HF-REF and HF-PEF (42.8 and 41.6% respectively). Compared with patients with normal Hb values, those with anaemia were older, were more likely to have diabetes, ischaemic aetiology, New York Heart Association class IV symptoms, lower estimated glomerular filtration rate and were more likely to be taking diuretic and less likely to be taking a beta-blocker. Patients with anaemia had higher all-cause mortality (adjusted hazard ratio [aHR] 1.38, 95% confidence interval [CI] 1.25-1.51), independent of EF group: aHR 1.67 (1.39-1.99) in HFPEF and aHR 2.49 (2.13-2.90) in HF-REF. Conclusions: Anaemia is an adverse prognostic factor in HF irrespective of EF. The prognostic importance of anaemia was greatest in patients with HF-REF.

AB - Background: Anaemia is common among patients with heart failure (HF) and is an important prognostic marker. Aim: We sought to determine the prognostic importance of anaemia in a large multinational pooled dataset of prospectively enrolled HF patients, with the specific aim to determine the prognostic role of anaemia in HF with preserved and reduced ejection fraction (HF-PEF and HF-REF, respectively). Design: Individual person data meta-analysis. Methods: Patients with haemoglobin (Hb) data fromthe MAGGIC dataset were used. Anaemia was defined as Hb < 120 g/l in women and <130 g/l inmen. HF-PEF was defined as EF ≥ 50%; HF-REF was EF < 50%. Cox proportional hazardmodelling, with adjustment for clinically relevant variables, was undertaken to investigate factors associated with 3-year all-causemortality. Results: Thirteen thousand two hundred and ninety-five patients with HF from 19 studies (9887 with HF-REF and 3408 with HF-PEF). The prevalence of anaemia was similar among those with HF-REF and HF-PEF (42.8 and 41.6% respectively). Compared with patients with normal Hb values, those with anaemia were older, were more likely to have diabetes, ischaemic aetiology, New York Heart Association class IV symptoms, lower estimated glomerular filtration rate and were more likely to be taking diuretic and less likely to be taking a beta-blocker. Patients with anaemia had higher all-cause mortality (adjusted hazard ratio [aHR] 1.38, 95% confidence interval [CI] 1.25-1.51), independent of EF group: aHR 1.67 (1.39-1.99) in HFPEF and aHR 2.49 (2.13-2.90) in HF-REF. Conclusions: Anaemia is an adverse prognostic factor in HF irrespective of EF. The prognostic importance of anaemia was greatest in patients with HF-REF.

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UR - http://www.scopus.com/inward/citedby.url?scp=84979071603&partnerID=8YFLogxK

U2 - 10.1093/qjmed/hcv087

DO - 10.1093/qjmed/hcv087

M3 - Article

C2 - 25979270

AN - SCOPUS:84979071603

VL - 109

SP - 377

EP - 382

JO - QJM - Monthly Journal of the Association of Physicians

JF - QJM - Monthly Journal of the Association of Physicians

SN - 1460-2725

IS - 6

ER -