CLINICAL STUDY
Anemia is associated with worse symptoms, greater impairment in functional capacity and a significant increase in mortality in patients with advanced heart failure
Tamara B. Horwich, MD*,
Gregg C. Fonarow, MD, FACC ,*,
Michele A. Hamilton, MD, FACC,
W. Robb MacLellan, MD, FACC and
Jeff Borenstein, MD
* Department of Medicine, University of California, Los Angeles, USA
Ahmanson–University of California Cardiomyopathy Center, Los Angeles, USA
Cedars–Sinai Health System, Los Angeles, California, USA
Manuscript received December 28, 2001;
revised manuscript received March 4, 2002,
accepted March 11, 2002.
* Reprint requests and correspondence: Dr. Gregg C. Fonarow, Ahmanson–UCLA Cardiomyopathy Center, UCLA Division of Cardiology, 47-123 CHS, 10833 Le Conte Avenue, Los Angeles, CA 90095-1679, USA.
gfonarow{at}mednet.ucla.edu
 |
Abstract
|
|---|
OBJECTIVES: This study aimed to evaluate the relationship between anemia and heart failure (HF) prognosis.
BACKGROUND: Although it is known that chronic diseases, including HF, may be associated with anemia, the impact of hemoglobin (Hb) level on symptoms and survival in HF has not been fully defined.
METHODS: We analyzed a cohort of 1,061 patients with advanced HF (New York Heart Association [NYHA] functional class III or IV and left ventricular ejection fraction [LVEF] <40%) referred to a single center for evaluation and management. The Hb level was drawn at time of initial evaluation. Patients were divided into quartiles of Hb: Hb <12.3; Hb 12.3 to 13.6; Hb 13.7 to 14.8; Hb >14.8 g/dl.
RESULTS: Mean Hb was 13.6, and values ranged from 7.1 to 19.0 g/dl. The Hb groups were similar in age, medication profile, LVEF, hypertension, diabetes, smoking status and serum sodium. Lower Hb was associated with an impaired hemodynamic profile, higher blood urea nitrogen and creatinine, and lower albumin, total cholesterol and body mass index. Patients in the lower Hb quartiles were more likely to be NYHA functional class IV (p < 0.0001) and have lower peak oxygen consumption (PKVO2) (p < 0.0001). Survival at one year was higher with increased Hb quartile (55.6%, 63.9%, 71.4% and 74.4% for quartiles 1, 2, 3 and 4, respectively). On multivariate analysis adjusting for known HF prognostic factors, low Hb proved to be an independent predictor of mortality (relative risk 1.131, confidence interval 1.045 to 1.224 for each decrease of 1 g/dl).
CONCLUSIONS: In chronic HF, relatively mild degrees of anemia are associated with worsened symptoms, functional status and survival.
|
Abbreviations and Acronyms
| | BMI | | body mass index | | CAD | | coronary artery disease | | CI | | confidence interval | | ESRD | | end-stage renal disease | | Hb | | hemoglobin | | Hct | | hematocrit | | HF | | heart failure | | LVEF | | left ventricular ejection fraction | | MI | | myocardial infarction | | NYHA | | New York Heart Association | | PKVO2 | | peak oxygen consumption | | RR | | relative risk | | SOLVD | | Studies Of Left Ventricular Dysfunction |
|
Heart failure (HF) is an increasingly important cause of morbidity and mortality, with prevalence in the U.S. recently estimated near 5 million. Although deaths from myocardial infarction (MI) and stroke have decreased by 50% over the past decade, mortality from HF has been steadily rising despite advances in medical and surgical therapy (1). Identification of modifiable risk factors for HF morbidity and mortality may lead to improvement in the clinical management of HF.
Recent reports have suggested that mild to moderate anemia is a prevalent condition in the HF patient population (2,3), and severe, chronic anemia has been associated with the de novo development of HF (4). However, the impact of the anemic state on symptoms and prognosis in patients with established HF has not been well-described in the medical literature. Current guidelines and reviews do not include anemia as a prognostic factor or treatment goal in HF (5,6).
The effect of hemoglobin (Hb) level on HF outcomes has been studied in certain patient populations. Anemia was a risk factor for development of HF as well as rehospitalization for HF in patients with end-stage renal disease (ESRD) (7). In patients with asymptomatic left ventricular dysfunction or mild to moderate HF, a recent analysis of patients enrolled in the Studies Of Left Ventricular Dysfunction (SOLVD) identified low Hb as a predictor of mortality independent of renal insufficiency (2). However, in HF patients who present the most significant management challenge to physicians, those with New York Heart Association (NYHA) functional class III and class IV, the interaction among Hb level, symptoms and prognosis is unknown.
Recently, several small clinical studies have investigated the correction of anemia with erythropoietin and iron as a treatment for HF. These initial studies have shown favorable results including improvement in left ventricular ejection fraction (LVEF), NYHA functional class and exercise capacity (8–10). Before larger trials are undertaken, it is necessary to have a more complete understanding of anemia’s role in the progression of advanced HF. To explore this issue further, we examined the relationship among Hb level, HF patient characteristics and symptoms, and HF survival in a cohort of NYHA functional class III and class IV HF patients of multiple etiologies.
|
Methods
|
|---|
Study subjects.
The study subjects were 1,733 patients referred to a single university medical center for heart transplant evaluation between 1983 and 1999. All subjects were followed in a comprehensive HF management program, as previously described (11). Medical record review was approved by the University of California-Los Angeles, Medical Institutional Review Board. Patients with LVEF >40% (n = 106), NYHA functional class <3 (n = 58) and those without an initial Hb level, "dry" weight or adequate follow-up data (n = 508) were excluded from analysis. The final study population consisted of 1,061 subjects.
Baseline data.
Both Hb and hematocrit (Hct) levels were determined at time of initial presentation. All specimens were analyzed in Centers for Disease Control-approved laboratories. The NYHA functional class was assessed at the time of initial presentation. Medical treatments recorded were those implemented after baseline hemodynamic evaluation. Hemodynamic variables utilized in the analyses were the optimal values recorded after pulmonary artery catheter-tailored medical therapy, as these hemodynamic measurements have been shown to best correlate with survival (12). Laboratory testing, electrocardiography, echocardiography and cardiopulmonary exercise tests all occurred within three months of initial referral; later values were excluded from our analysis. Creatinine clearance was calculated by the Cockcroft-Gault formula using the patient’s "dry" weight after hemodynamically guided therapy. Hypertension, diabetes and smoking histories were based on medical record review.
End points.
Death was the primary end point in this study. Deaths were classified as sudden death, HF death or death secondary to MI. Death was considered sudden if it was unexpected based on the patient’s clinical status and if it occurred out of the hospital within 15 min of the onset of unexpected symptoms or during sleep. Death during hospitalization for worsening congestive symptoms was considered an HF death. Urgent heart transplants (Status I) were analyzed as deaths, under the assumption that these patients would have died without a transplant. Nonurgent transplants (Status II) were considered a nonfatal end of follow-up.
Statistical analysis.
Data are presented as mean ± SD for continuous variables and as frequencies for categorical variables. Patients were divided into quartiles of Hb. Differences in baseline characteristics among quartiles were analyzed using analysis of variance for continuous variables and Pearson’s chi-square test for categorical variables. To evaluate differences between survivors and nonsurvivors, we used an independent sample t test for continuous variables and Pearson’s chi-square test for categorical variables. Both one-year and five-year survival curves were calculated with the Kaplan-Meier method, and differences between the curves were evaluated with the log-rank statistic. We assessed the relationship between baseline variables and mortality using a Cox proportional hazards survival model (SPSS for Windows, version 10.0.5). Hazard ratios (relative risk [RR]) with 95% confidence intervals (CI) demonstrate the risk of death when a variable is present. The multivariate Cox model included the following variables seen to be predictors of mortality on univariate analysis as well as other known factors for HF mortality: age, gender, body mass index (BMI), left ventricular end diastolic dimension, hypertension history, diabetes history, smoking history, serum sodium, albumin, creatinine and HF etiology.
|
Results
|
|---|
Baseline characteristics of the cohort.
The cohort was 77% male, and ages ranged from 16 to 82 years. The NYHA functional class III and IV patients comprised 35% and 65% of the population, respectively, and mean LVEF was 22%. Etiologies of HF were ischemic (50%), idiopathic (38%) and valvular (4.5%); the remaining 7.5% included alcohol-induced, hypertrophic and postpartum cardiomyopathy.
Mean Hb was 13.6 ± 1.9 g/dl and Hb ranged from 7.1 to 19.0 g/dl. The mean Hb level for women was 12.7 ± 1.8 g/dl and for men was 13.8 ± 1.9 g/dl. Of both men and women in the cohort, 30% were considered anemic when anemia was defined as Hb <13 g/dl in men and Hb <12 g/dl in women (13). Hemoglobin level >17 g/dl was seen in 3% of men and 1% of women.
Relationship between hb level and baseline characteristics.
Differences among the Hb quartiles are detailed in Table 1. Age, past medical history, LVEF, etiology of HF, serum sodium and medication usage were similar among the Hb groups. Patients in the lower quartiles were more likely to be women. Lower Hb levels were associated with greater symptoms, as evident by more patients being NYHA functional class IV (75.3%, 68.0%, 56.7% and 59.1% for quartiles 1, 2, 3 and 4, respectively, p < 0.0001). Lower BMI and albumin and impaired renal function were seen in the lower Hb quartiles. The hemodynamic profile of the patients in the lower quartiles were characterized by lower blood pressure, but higher heart rate and pulmonary capillary wedge pressure (Table 1). Greater impairment in exercise capacity was demonstrated in HF patients with lower Hb concentrations. Peak oxygen consumption (PKVO2) on cardiopulmonary exercise testing was 12.8 ± 4.6, 12.4 ± 4.5, 13.8 ± 4.7 and 14.6 ± 5.4 ml/kg per min for quartiles 1, 2, 3 and 4, respectively, p < 0.0001.
Relationship between hb and mortality.
There were 212 deaths by year one, and 360 deaths at five-year follow-up. At one year, progressive HF death accounted for 98 deaths (46%), while 89 deaths were sudden, 5 occurred secondary to MI and 20 occurred from unknown or other causes. At the end of one year, 247 of the 1,061 patients had received heart transplants (126 urgent, Status 1; 148 nonurgent, Status 2). At five-year follow-up, 405 patients received heart transplants.
A low baseline Hb level in this cohort of advanced HF patients proved to be a significant predictor of subsequent mortality. The Hb level was significantly higher in patients alive at one year compared to those who had died or had undergone urgent transplant at one year. Table 2 details the differences in baseline characteristics between survivors and nonsurvivors at one year. On univariate Cox regression analysis, each 1 g/dl decrease in Hb was associated with a 16% increased risk of death. Hemoglobin was similarly predictive of mortality at five-year follow-up (data not shown). Survival rates steadily declined as Hb quartile decreased, as shown in the Kaplan-Meier survival curves for the four Hb quartiles (Fig. 1). This stepwise trend was preserved after the cohort was further subdivided by Hb deciles, with no evidence of a U-shaped relationship (Fig. 2).
After adjusting for variables found to be significant predictors of mortality on univariate analysis, Hb level maintained its significant prognostic value. On multivariate analysis, the risk of mortality increased by 13% for each decrease by 1 g/dl in Hb (RR 1.131, CI 1.045 to 1.224). Independent predictors of mortality, as determined by multivariate analysis, are detailed in Table 3.
Kaplan-Meier survival curves were recalculated in clinically significant subgroups to determine whether Hb maintained its prognostic value in these subsets of HF patients. The association between low Hb and increased mortality was preserved in subsets of patients with and without coronary artery disease (CAD) as well as patients both older and younger than the median age of 53 years (Fig. 3). Because healthy women have lower Hb levels than healthy men, we separated each gender group into quartiles before recalculating survival curves. Hemoglobin was predictive of mortality in both men and women, yet the association was stronger in men (Fig. 3). The relationship between Hb and mode of death was also investigated, revealing that Hb was a significant predictor of progressive HF death (p = 0.00001), but not sudden death (p = 0.73). After exclusion of patients who received heart transplants, higher mortality rates were still observed in patients with lower Hb (p < 0.005) (Fig. 3). On multivariate analysis, lower Hb remained a significant predictor of increased mortality (RR 1.129, CI 1.018 to 1.251).
View larger version (41K):
[in this window]
[in a new window]
|
Figure 3 Mortality by hemoglobin quartile (Q) for the total cohort compared to subgroups of men (Q1 <12.6; Q2 12.6–13.9; Q3 14.0–15.0; Q4 >15.0 g/dl) and women (Q1 <11.6; Q2 11.6–12.6; Q3 12.7–13.8; Q4 >13.8 g/dl), patients with ischemic and nonischemic cardiomyopathy (CMY), and excluding patients who underwent urgent or elective status transplantation.
|
|
|
Discussion
|
|---|
Major findings.
Our study, which examined Hb level in a large, well-characterized cohort of advanced HF patients, demonstrates that Hb is significantly associated with symptoms, exercise capacity, and prognosis in patients with advanced HF. Several findings deserve emphasis. First, although the relationship between anemia and adverse outcomes has been described in patients with ESRD (7) and patients with asymptomatic left ventricular dysfunction or mild to moderate HF (2), our study extends this finding to patients with advanced HF. The relationship between anemia and mortality persists in subgroups based on gender, age and HF etiology, and it is independent of other established HF prognostic factors. Furthermore, based on our analysis of Hb deciles, we have observed that mortality decreases in linear fashion as Hb level increases, without excess mortality at the highest Hb levels.
A second point of emphasis is the relatively mild degrees of anemia associated with increased morbidity and mortality; significantly impaired survival was seen in women with Hb <11.6 g/dl and men with Hb <12.6 g/dl, values that may not be considered significant or associated with increased risk in clinical practice. Third, patients with decreased Hb were characterized by an unfavorable hemodynamic profile, worse symptoms of HF, as described by NYHA functional class, and greater impairment in exercise capacity, as quantified by PKVO2. Based on this analysis it would be predicted that correction of anemia would be associated with an improvement in exercise capacity of approximately 2 ml/kg/min, which has previously been shown to be clinically relevant (14). Interestingly, that was the magnitude of improvement in exercise capacity recently observed in a small trial of 12 weeks of erythropoietin therapy in patients with anemia and HF (10).
Epidemiologic evidence.
Prior epidemiologic studies that have included Hb or Hct in their analyses provide supportive evidence for the significant relationship between anemia, HF and prognosis. Anemia was associated with an increased risk of death or HF rehospitalization in California patients hospitalized for HF between 1991 and 1992 (15). Furthermore, the Framingham Heart Study found Hct to be a significant risk factor for increased HF incidence (16).
Although the present study describes a remarkable association between anemia and HF mortality, the pathophysiologic relationship between Hb and HF progression requires further study. Hemoglobin may be a marker of poor prognosis in HF or, conversely, it may play a causative role in HF progression. Several potential explanations for the association between low Hb and poor prognosis deserve exploration.
Anemia of chronic disease.
Increased levels of plasma cytokines such as tumor necrosis factor in HF patients are associated with higher NYHA functional class (17) and increased HF mortality (18). Anemia in advanced HF may be a marker of increased levels of circulating cytokines and cytokine receptors. It is known that anemia commonly seen in chronic inflammatory states, such as some infections, neoplasm and rheumatologic conditions, is mediated by inflammatory cytokines such as tumor necrosis factor, interleukin-1 and the interferons (19). It may be that the anemia in HF is similar to that seen in other chronic diseases and is likewise mediated by elevated circulating cytokines. As with anemia of other chronic disease states, increased erythropoietin levels have been found in patients with chronic heart failure (20).
Malnutrition.
In our study, patients in the lower Hb quartiles were characterized by markers of malnutrition, such as lower levels of albumin and lower BMI (Table 1). Malnutrition is a common causative factor in the development of anemia in non-HF populations, such as the elderly (21). It is possible that the poor prognosis of anemia in HF stems from malnutrition due to cardiac cachexia, a catabolic state seen in advanced HF and associated with increased HF mortality (22). However, Hb was predictive of mortality independent of BMI and albumin levels.
Hemodilution.
Low Hb may be a marker of volume overload in poorly compensated, high-risk HF patients. Previous studies have demonstrated that decreased Hb or Hct in HF is reflective of plasma volume expansion and not necessarily indicative of decreased red blood cell volume (23). Because Hb was predictive of mortality independent of pulmonary capillary wedge pressure after hemodynamically guided diuresis, hemodilution alone cannot fully account for these findings.
Anemia and ischemia.
Although it has been shown that the resting, healthy human heart can withstand acute, severe anemia without sustaining myocardial ischemia (24), the presence of CAD may significantly impair the heart’s ability to tolerate low levels of Hb (25). A recent observational study showed reduction in 30-day mortality in patients with Hct <33% who received blood transfusion during hospitalization for MI compared to those who were not transfused (26). Anemia in HF patients may predispose to myocardial ischemia, repetitive stunning, apoptosis, and necrosis, thus contributing to the progression of ventricular dilation and clinical HF.
Renal insufficiency.
The kidney and its related hormonal mechanisms play a fundamental role in the pathophysiology of HF. Impaired renal function is associated with both anemia and worse prognosis in patients with HF. Although lower Hb was associated with higher blood urea nitrogen and creatinine and lower creatinine clearance, the increased mortality risk seen remained after adjustment for renal function and other HF prognostic factors. Similarly, in the SOLVD analysis the increased mortality risk with anemia in HF was independent of renal function impairment (2). It should be noted, however, that in a randomized clinical trial involving patients with ESRD and HF, normalization of Hct (42%) with erythropoietin and intravenous (IV) iron dextran compared to maintaining lower Hct levels (30%) was associated with a trend for increased nonfatal MIs and mortality (RR 1.3; 95% CI 0.9 to 1.9, p = NS) (27).
Study limitations.
Our study is retrospective and examines a selected population of HF patients with advanced disease referred for transplant evaluation. Hemoglobin levels were assessed at a single point in time, and thus we cannot comment on the importance in change in Hb over time. Treatment of anemia with transfusion or other medications during the time course of the study is also not documented or included in the analysis, though it was not routine to treat these patients with transfusions, iron or erythropoietin. Data on the use of beta-blockers or addition of medicines after the time of initial presentation are not included in the analysis. We also do not have data on cytokine or erythropoietin levels, or direct measures of plasma volume or red blood cell mass, information that would help in understanding the pathophysiologic role of anemia in HF progression.
Conclusions.
Lower Hb is associated with greater functional impairment, worse exercise capacity, and increased mortality in this cohort of advanced HF patients of multiple etiologies. Further studies aimed at understanding the interaction between Hb and HF progression are needed. Initial studies suggest that treatment of anemia is beneficial in HF (8). Additional randomized, placebo-controlled studies are warranted to test the hypothesis that correction of anemia improves symptoms and exercise capacity in advanced HF and also to determine whether treatment of anemia has an impact on HF survival.
|
Footnotes
|
|---|
This study was supported by the Ahmanson Foundation, Los Angeles, California, and Amgen, Thousand Oaks, California.
|
References
|
|---|
1. Massie BM, Shah NB. Evolving trends in the epidemiologic factors of heart failure: rationale for preventive strategies and comprehensive disease management. Am Heart J. 1997;133:703–712[CrossRef][Medline]
2. Al-Ahmad A, Rand SM, Manjunath G, et al. Reduced kidney function and anemia as risk factors for mortality in patients with left ventricular dysfunction. J Am Coll Cardiol. 2001;38:955–962[Abstract/Free Full Text]
3. Rich MW, Beckham V, Wittenberg C, et al. A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure. N Engl J Med. 1995;333:1190–1195[Abstract/Free Full Text]
4. Stone RM, Ridges KR, Libby P. Hematological-oncological disorders and cardiovascular disease. Braunwald. Heart Disease: A Textbook of Cardiovascular Medicine. 6th ed. Philadelphia, PA: W.B. Saunders; 2001.
5. Cowburn PJ, Cleland JG, Coats AS, et al. Risk stratification in chronic heart failure. Eur Heart J. 1998;19:696–710[Free Full Text]
6. Hunt SA, Baker DW, Chin MH, et al. ACC/AHA Guidelines for the evaluation and management of chronic heart failure in the adult: executive summary: report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart FailureJ Am Coll Cardiol. 2001;38:2101–2113[Free Full Text]
7. Foley RN, Parfrey PS, Harnett HD, et al. The impact of anemia on cardiomyopathy, morbidity, and mortality in end-stage renal disease. Am J Kidney Dis. 1996;28:53–61[Medline]
8. Silverberg DS, Wexler D, Sheps D, et al. The effect of correction of mild anemia in severe, resistant congestive heart failure using subcutaneous erythropoietin and intravenous iron: a randomized controlled study. J Am Coll Cardiol. 2001;37:1775–1780[Abstract/Free Full Text]
9. Silverberg DS, Wexler D, Blum M, et al. The use of subcutaneous erythropoietin and intravenous iron for the treatment of the anemia of severe, resistant congestive heart failure improves cardiac and renal function, and functional cardiac class, and markedly reduces hospitalizations. J Am Coll Cardiol. 2000;35:1737–1744[Abstract/Free Full Text]
10. Mancini D, Katz S, Lamanca J, et al. Erythropoietin improves exercise capacity in patients with heart failure (abstr). Circulation. 2001;104:II438
11. Fonarow GC, Stevenson LW, Walden JA, et al. Impact of a comprehensive heart failure management program on hospital readmission and functional status of patients with advanced heart failure. J Am Coll Cardiol. 1997;30:725–731[Abstract]
12. Stevenson LW, Tillisch JH, Hamilton MA, et al. The importance of hemodynamic response to therapy in predicting survival with ejection fraction  20% secondary to ischemic or nonischemic dilated cardiomyopathy. Am J Cardiol. 1990;66:1348–1354[CrossRef][Medline]
13. World Health Organization. Nutritional anaemias: Report of a WHO scientific group. 6th ed. Geneva, Switzerland: World Health Organization; 1968.
14. Stevenson LW, Steimle AE, Fonarow GC, et al. Improvement in exercise capacity of candidates awaiting heart transplantation. J Am Coll Cardiol. 1995;25:163–170[Abstract]
15. Alexander M, Grumbach K, Remy L, Rowell R, Massie B. Congestive heart failure hospitalizations and survival in California: patterns according to race/ethnicity. Am Heart J. 1999;137:919–927[CrossRef][Medline]
16. Kannel WB. Epidemiology and prevention of cardiac failure: Framingham Study insights. Eur Heart J. 1987;8F:23–29
17. Rauchhaus M, Doehner W, Francis DP, et al. Plasma cytokine parameters and mortality in patients with chronic heart failure. Circulation. 2000;102:3060–3067[Abstract/Free Full Text]
18. Deswal A, Petersen NJ, Feldman AM, Young JB, White BG, Mann DL. Cytokines and cyokine receptors in advanced heart failure. Circulation. 2001;103:2055–2059[Abstract/Free Full Text]
19. Means RT. Pathogenesis of the anemia of chronic disease: a cytokine-mediated anemia. Stem Cells. 1995;13:32–37[Medline]
20. Volpe M, Tritto C, Testa U, et al. Blood levels of erythropoietin in congestive heart failure and correlation with clinical, hemodynamic, and hormonal profiles. Am J Cardiol. 1994;74:468–473[CrossRef][Medline]
21. Mitrache C, Passweg JR, Libura J, et al. Anemia: an indicator for malnutrition in the elderly. Ann Hematol. 2001;80:295–298[CrossRef][Medline]
22. Anker SD, Ponikowski P, Varney S, et al. Wasting as independent risk factor for mortality in chronic heart failure. Lancet. 1997;349:1050–1053[CrossRef][Medline]
23. Androne AS, Hryniewiz K, Hudaihed A, Mancini D, Katz SD. Clinical correlates of 131I-albumin blood volume determination in non-edematous patients with chronic heart failure (abstr). J Card Fail. 2001;7:S13
24. Weiskopf RB, Viele Mk, Feiner J, et al. Human cardiovascular and metabolic response to acute, severe isovolemic anemia. JAMA. 1998;279:217–221[Abstract/Free Full Text]
25. Levy PS, Kim SJ, Eckel PK, et al. Limit to cardiac compensation during acute isovolemic hemodilution: influence of coronary stenosis. Am J Physiol. 1993;265:H340–349[Medline]
26. Wu WC, Rathore SS, Wang Y, Radford MJ, Krumholz HM. Blood transfusion in elderly patients with acute myocardial infarction. N Engl J Med. 2001;345:1230–1236[Abstract/Free Full Text]
27. Besarab A, Bolton WK, Browne JK, et al. The effects of normal as compared with low hematocrit values in patients with cardiac disease who are receiving hemodialysis and epoetin. N Engl J Med. 1998;339:584–590[Abstract/Free Full Text]
This article has been cited by other articles:
|
|
|
|
 
M. Klapholz, W. T. Abraham, J. K. Ghali, P. Ponikowski, S. D. Anker, B. Knusel, Y. Sun, S. M. Wasserman, and D. J. van Veldhuisen
The safety and tolerability of darbepoetin alfa in patients with anaemia and symptomatic heart failure
Eur J Heart Fail,
November 1, 2009;
11(11):
1071 - 1077.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Goei, W.-J. Flu, S. E. Hoeks, W. Galal, M. Dunkelgrun, E. Boersma, R. Kuijper, J.-P. van Kuijk, T. A. Winkel, O. Schouten, et al.
The Interrelationship Between Preoperative Anemia and N-Terminal Pro-B-Type Natriuretic Peptide: The Effect on Predicting Postoperative Cardiac Outcome in Vascular Surgery Patients
Anesth. Analg.,
November 1, 2009;
109(5):
1403 - 1408.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Vrtovec, R. Radovancevic, R. M. Delgado, B. Radovancevic, A. W. Bracey, I. D. Gregoric, and O.H. Frazier
Significance of anaemia in patients with advanced heart failure receiving long-term mechanical circulatory support
Eur J Heart Fail,
October 1, 2009;
11(10):
1000 - 1004.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. A. Pascual-Figal, J. C. Bonaque, B. Redondo, C. Caro, S. Manzano-Fernandez, J. Sanchez-Mas, I. P. Garrido, and M. Valdes
Red blood cell distribution width predicts long-term outcome regardless of anaemia status in acute heart failure patients
Eur J Heart Fail,
September 1, 2009;
11(9):
840 - 846.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. D. Anker, A. Voors, D. Okonko, A. L. Clark, M. K. James, S. von Haehling, J. Kjekshus, P. Ponikowski, K. Dickstein, and for the OPTIMAAL Investigators
Prevalence, incidence, and prognostic value of anaemia in patients after an acute myocardial infarction: data from the OPTIMAAL trial
Eur. Heart J.,
June 1, 2009;
30(11):
1331 - 1339.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. A. Hunt, W. T. Abraham, M. H. Chin, A. M. Feldman, G. S. Francis, T. G. Ganiats, M. Jessup, M. A. Konstam, D. M. Mancini, K. Michl, et al.
2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the International Society for Heart and Lung Transplantation
J. Am. Coll. Cardiol.,
April 14, 2009;
53(15):
e1 - e90.
[Full Text]
[PDF]
|
|
|
|
|
|
|
2005 WRITING COMMITTEE MEMBERS, S. A. Hunt, W. T. Abraham, M. H. Chin, A. M. Feldman, G. S. Francis, T. G. Ganiats, M. Jessup, M. A. Konstam, D. M. Mancini, et al.
2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: Developed in Collaboration With the International Society for Heart and Lung Transplantation
Circulation,
April 14, 2009;
119(14):
e391 - e479.
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. A. Krikorian
Managing Anemia of Chronic Kidney Disease
American Journal of Lifestyle Medicine,
March 1, 2009;
3(2):
135 - 146.
[Abstract]
[PDF]
|
|
|
|
|
|
|
Y. Naito, T. Tsujino, M. Matsumoto, T. Sakoda, M. Ohyanagi, and T. Masuyama
Adaptive response of the heart to long-term anemia induced by iron deficiency
Am J Physiol Heart Circ Physiol,
March 1, 2009;
296(3):
H585 - H593.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Gao and W. J. Koch
Is erythropoietin behind maladaptive anemic heart failure?
Am J Physiol Heart Circ Physiol,
March 1, 2009;
296(3):
H559 - H560.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Kazory and E. A. Ross
Anemia: the point of convergence or divergence for kidney disease and heart failure?
J. Am. Coll. Cardiol.,
February 24, 2009;
53(8):
639 - 647.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. D. Pagourelias, C. Koumaras, A. I. Kakafika, K. Tziomalos, P. G. Zorou, V. G. Athyros, and A. Karagiannis
Cardiorenal Anemia Syndrome: Do Erythropoietin and Iron Therapy Have a Place in the Treatment of Heart Failure?
Angiology,
February 1, 2009;
60(1):
74 - 81.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C. Adlbrecht, S. Kommata, M. Hulsmann, T. Szekeres, C. Bieglmayer, G. Strunk, G. Karanikas, R. Berger, D. Mortl, K. Kletter, et al.
Chronic heart failure leads to an expanded plasma volume and pseudoanaemia, but does not lead to a reduction in the body's red cell volume
Eur. Heart J.,
October 1, 2008;
29(19):
2343 - 2350.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. M. T. Hare, A. K. Y. Tsui, A. T. McLaren, T. E. Ragoonanan, J. Yu, and C. D. Mazer
Anemia and Cerebral Outcomes: Many Questions, Fewer Answers
Anesth. Analg.,
October 1, 2008;
107(4):
1356 - 1370.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. F. Groenveld, J. L. Januzzi, K. Damman, J. van Wijngaarden, H. L. Hillege, D. J. van Veldhuisen, and P. van der Meer
Anemia and Mortality in Heart Failure Patients: A Systematic Review and Meta-Analysis
J. Am. Coll. Cardiol.,
September 2, 2008;
52(10):
818 - 827.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. S. Anand
Anemia and Chronic Heart Failure: Implications and Treatment Options
J. Am. Coll. Cardiol.,
August 12, 2008;
52(7):
501 - 511.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Kazory and E. A. Ross
Contemporary Trends in the Pharmacological and Extracorporeal Management of Heart Failure: A Nephrologic Perspective
Circulation,
February 19, 2008;
117(7):
975 - 983.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W.H. W. Tang, W. Tong, A. Jain, G. S. Francis, C. M. Harris, and J. B. Young
Evaluation and long-term prognosis of new-onset, transient, and persistent anemia in ambulatory patients with chronic heart failure.
J. Am. Coll. Cardiol.,
February 5, 2008;
51(5):
569 - 576.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. K. Ghali, I. S. Anand, W. T. Abraham, G. C. Fonarow, B. Greenberg, H. Krum, B. M. Massie, S. M. Wasserman, M.-L. Trotman, Y. Sun, et al.
Randomized Double-Blind Trial of Darbepoetin Alfa in Patients With Symptomatic Heart Failure and Anemia
Circulation,
January 29, 2008;
117(4):
526 - 535.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Nybo, M. Benn, R. Mogelvang, J. S. Jensen, P. Schnohr, J. F. Rehfeld, and J. P. Goetze
Impact of Hemoglobin on Plasma Pro-B-Type Natriuretic Peptide Concentrations in the General Population
Clin. Chem.,
November 1, 2007;
53(11):
1921 - 1927.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. E. Toblli, A. Lombrana, P. Duarte, and F. Di Gennaro
Intravenous Iron Reduces NT-Pro-Brain Natriuretic Peptide in Anemic Patients With Chronic Heart Failure and Renal Insufficiency
J. Am. Coll. Cardiol.,
October 23, 2007;
50(17):
1657 - 1665.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. S. Desai, K. Bibbins-Domingo, M. G. Shlipak, A. H.B. Wu, S. Ali, and M. A. Whooley
Association between anaemia and N-terminal pro-B-type natriuretic peptide (NT-proBNP): Findings from the Heart and Soul Study
Eur J Heart Fail,
September 1, 2007;
9(9):
886 - 891.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. Schwenger, C. Morath, and M. Zeier
Use of Erythropoietin after solid organ transplantation
Nephrol. Dial. Transplant.,
September 1, 2007;
22(suppl_8):
viii47 - viii49.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. P. Steensma and A. Tefferi
Anemia in the Elderly: How Should We Define It, When Does It Matter, and What Can Be Done?
Mayo Clin. Proc.,
August 1, 2007;
82(8):
958 - 966.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Cote, M. D. Zilberberg, S. H. Mody, L. J. Dordelly, and B. Celli
Haemoglobin level and its clinical impact in a cohort of patients with COPD
Eur. Respir. J.,
May 1, 2007;
29(5):
923 - 929.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. C. Inglis, S. Stewart, A. Papachan, V. Vaghela, C. Libhaber, Y. Veriava, and K. Sliwa
Anaemia and renal function in heart failure due to idiopathic dilated cardiomyopathy
Eur J Heart Fail,
April 1, 2007;
9(4):
384 - 390.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Komajda
Anemia in Chronic Heart Failure: Should We Treat It and How?
J. Am. Coll. Cardiol.,
February 20, 2007;
49(7):
763 - 764.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Ponikowski, S. D. Anker, J. Szachniewicz, D. Okonko, M. Ledwidge, R. Zymlinski, E. Ryan, S. M. Wasserman, N. Baker, D. Rosser, et al.
Effect of Darbepoetin Alfa on Exercise Tolerance in Anemic Patients With Symptomatic Chronic Heart Failure: A Randomized, Double-Blind, Placebo-Controlled Trial
J. Am. Coll. Cardiol.,
February 20, 2007;
49(7):
753 - 762.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. D. Westenbrink, F. W. Visser, A. A. Voors, T. D.J. Smilde, E. Lipsic, G. Navis, H. L. Hillege, W. H. van Gilst, and D. J. van Veldhuisen
Anaemia in chronic heart failure is not only related to impaired renal perfusion and blunted erythropoietin production, but to fluid retention as well
Eur. Heart J.,
January 2, 2007;
28(2):
166 - 171.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. N. Nanas, C. Matsouka, D. Karageorgopoulos, A. Leonti, E. Tsolakis, S. G. Drakos, E. P. Tsagalou, G. D. Maroulidis, G. P. Alexopoulos, J. E. Kanakakis, et al.
Etiology of Anemia in Patients With Advanced Heart Failure
J. Am. Coll. Cardiol.,
December 19, 2006;
48(12):
2485 - 2489.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Falk, K. Swedberg, F. Gaston-Johansson, and I. Ekman
Fatigue and anaemia in patients with chronic heart failure
Eur J Heart Fail,
November 1, 2006;
8(7):
744 - 749.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. Valeur, O. W. Nielsen, J. J.V. McMurray, C. Torp-Pedersen, L. Kober, and TRACE Study Group
Anaemia is an independent predictor of mortality in patients with left ventricular systolic dysfunction following acute myocardial infarction
Eur J Heart Fail,
October 1, 2006;
8(6):
577 - 584.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. G. Coca, H. M. Krumholz, A. X. Garg, and C. R. Parikh
Underrepresentation of renal disease in randomized controlled trials of cardiovascular disease.
JAMA,
September 20, 2006;
296(11):
1377 - 1384.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. Ripamonti, V. Racca, M. G. Calvo, P. Castiglioni, and M. Ferratini
Angiotensin-converting enzyme inhibitors slow recovery from anemia following cardiac surgery.
Chest,
July 1, 2006;
130(1):
79 - 84.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. S. Go, J. Yang, L. M. Ackerson, K. Lepper, S. Robbins, B. M. Massie, and M. G. Shlipak
Hemoglobin Level, Chronic Kidney Disease, and the Risks of Death and Hospitalization in Adults With Chronic Heart Failure: The Anemia in Chronic Heart Failure: Outcomes and Resource Utilization (ANCHOR) Study
Circulation,
June 13, 2006;
113(23):
2713 - 2723.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Komajda, S. D. Anker, A. Charlesworth, D. Okonko, M. Metra, A. Di Lenarda, W. Remme, C. Moullet, K. Swedberg, J. G.F. Cleland, et al.
The impact of new onset anaemia on morbidity and mortality in chronic heart failure: results from COMET
Eur. Heart J.,
June 2, 2006;
27(12):
1440 - 1446.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L Grigorian Shamagian, A Varela Roman, J M Garcia-Acuna, P Mazon Ramos, A Virgos Lamela, and J R Gonzalez-Juanatey
Anaemia is associated with higher mortality among patients with heart failure with preserved systolic function
Heart,
June 1, 2006;
92(6):
780 - 784.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y.-D. Tang and S. D. Katz
Anemia in Chronic Heart Failure: Prevalence, Etiology, Clinical Correlates, and Treatment Options
Circulation,
May 23, 2006;
113(20):
2454 - 2461.
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. O'Meara, T. Clayton, M. B. McEntegart, J. J.V. McMurray, C. C. Lang, S. D. Roger, J. B. Young, S. D. Solomon, C. B. Granger, J. Ostergren, et al.
Clinical Correlates and Consequences of Anemia in a Broad Spectrum of Patients With Heart Failure: Results of the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) Program
Circulation,
February 21, 2006;
113(7):
986 - 994.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Similowski, A. Agusti, W. MacNee, and B. Schonhofer
The potential impact of anaemia of chronic disease in COPD
Eur. Respir. J.,
February 1, 2006;
27(2):
390 - 396.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. M. Felker, W. G. Stough, L. K. Shaw, and C. M. O'Connor
Anaemia and coronary artery disease severity in patients with heart failure
Eur J Heart Fail,
January 1, 2006;
8(1):
54 - 57.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. G. N. Agusti
Systemic Effects of Chronic Obstructive Pulmonary Disease
Proceedings of the ATS,
November 1, 2005;
2(4):
367 - 370.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Opasich, M. Cazzola, L. Scelsi, S. De Feo, E. Bosimini, R. Lagioia, O. Febo, R. Ferrari, A. Fucili, R. Moratti, et al.
Blunted erythropoietin production and defective iron supply for erythropoiesis as major causes of anaemia in patients with chronic heart failure
Eur. Heart J.,
November 1, 2005;
26(21):
2232 - 2237.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. T. Vlagopoulos, H. Tighiouart, D. E. Weiner, J. Griffith, D. Pettitt, D. N. Salem, A. S. Levey, and M. J. Sarnak
Anemia as a Risk Factor for Cardiovascular Disease and All-Cause Mortality in Diabetes: The Impact of Chronic Kidney Disease
J. Am. Soc. Nephrol.,
November 1, 2005;
16(11):
3403 - 3410.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. A. Zakai, R. Katz, C. Hirsch, M. G. Shlipak, P. H. M. Chaves, A. B. Newman, and M. Cushman
A Prospective Study of Anemia Status, Hemoglobin Concentration, and Mortality in an Elderly Cohort: The Cardiovascular Health Study
Arch Intern Med,
October 24, 2005;
165(19):
2214 - 2220.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Kosiborod, J. P. Curtis, Y. Wang, G. L. Smith, F. A. Masoudi, J. M. Foody, E. P. Havranek, and H. M. Krumholz
Anemia and Outcomes in Patients With Heart Failure: A Study From the National Heart Care Project
Arch Intern Med,
October 24, 2005;
165(19):
2237 - 2244.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Developed in Collaboration With the American Colle, Endorsed by the Heart Rhythm Society, S. A. Hunt, W. T. Abraham, M. H. Chin, A. M. Feldman, G. S. Francis, T. G. Ganiats, M. Jessup, M. A. Konstam, et al.
ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult--Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure)
J. Am. Coll. Cardiol.,
September 20, 2005;
46(6):
1116 - 1143.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. van der Meer, E. Lipsic, B. D. Westenbrink, R. M.A. van de Wal, R. G. Schoemaker, E. Vellenga, D. J. van Veldhuisen, A. A. Voors, and W. H. van Gilst
Levels of Hematopoiesis Inhibitor N-Acetyl-Seryl-Aspartyl-Lysyl-Proline Partially Explain the Occurrence of Anemia in Heart Failure
Circulation,
September 20, 2005;
112(12):
1743 - 1747.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. A. Hunt, W. T. Abraham, M. H. Chin, A. M. Feldman, G. S. Francis, T. G. Ganiats, M. Jessup, M. A. Konstam, D. M. Mancini, K. Michl, et al.
ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult--Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): Developed in Collaboration With the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: Endorsed by the Heart Rhythm Society
Circulation,
September 20, 2005;
112(12):
1825 - 1852.
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. S. Anand, M. A. Kuskowski, T. S. Rector, V. G. Florea, R. D. Glazer, A. Hester, Y. T. Chiang, N. Aknay, A. P. Maggioni, C. Opasich, et al.
Anemia and Change in Hemoglobin Over Time Related to Mortality and Morbidity in Patients With Chronic Heart Failure: Results From Val-HeFT
Circulation,
August 23, 2005;
112(8):
1121 - 1127.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. van der Meer, E. Lipsic, R. H. Henning, K. Boddeus, J. van der Velden, A. A. Voors, D. J. van Veldhuisen, W. H. van Gilst, and R. G. Schoemaker
Erythropoietin Induces Neovascularization and Improves Cardiac Function in Rats With Heart Failure After Myocardial Infarction
J. Am. Coll. Cardiol.,
July 5, 2005;
46(1):
125 - 133.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Authors/Task Force Members, K. Swedberg, Writing Committee:, J. Cleland, H. Dargie, H. Drexler, F. Follath, M. Komajda, L. Tavazzi, O. A. Smiseth, et al.
Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005): The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology
Eur. Heart J.,
June 1, 2005;
26(11):
1115 - 1140.
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Namiuchi, Y. Kagaya, J. Ohta, N. Shiba, M. Sugi, M. Oikawa, H. Kunii, H. Yamao, N. Komatsu, M. Yui, et al.
High Serum Erythropoietin Level Is Associated With Smaller Infarct Size in Patients With Acute Myocardial Infarction Who Undergo Successful Primary Percutaneous Coronary Intervention
J. Am. Coll. Cardiol.,
May 3, 2005;
45(9):
1406 - 1412.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Philipp, H. Ollmann, T. Schink, R. Dietz, F. C. Luft, and R. Willenbrock
The impact of anaemia and kidney function in congestive heart failure and preserved systolic function
Nephrol. Dial. Transplant.,
May 1, 2005;
20(5):
915 - 919.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
U. Dahlstrom
Frequent non-cardiac comorbidities in patients with chronic heart failure
Eur J Heart Fail,
March 16, 2005;
7(3):
309 - 316.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. John, S. Hoernig, W. Doehner, D. D. Okonko, C. Witt, and S. D. Anker
Anemia and Inflammation in COPD
Chest,
March 1, 2005;
127(3):
825 - 829.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Ishani, E. Weinhandl, Z. Zhao, D. T. Gilbertson, A. J. Collins, S. Yusuf, and C. A. Herzog
Angiotensin-converting enzyme inhibitor as a risk factor for the development of anemia, and the impact of incident anemia on mortality in patients with left ventricular dysfunction
J. Am. Coll. Cardiol.,
February 1, 2005;
45(3):
391 - 399.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Caiola and J. W. Cheng
Use of Erythropoietin in Heart Failure Management
Ann. Pharmacother.,
December 1, 2004;
38(12):
2145 - 2149.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G.M. Felker, K. F. Adams Jr, W. A. Gattis, and C. M. O'Connor
Anemia as a risk factor and therapeutic target in heart failure
J. Am. Coll. Cardiol.,
September 1, 2004;
44(5):
959 - 966.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A J S Coats
Anaemia and heart failure
Heart,
September 1, 2004;
90(9):
977 - 979.
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Nikolsky, E. D. Aymong, A. Halkin, C. L. Grines, D. A. Cox, E. Garcia, R. Mehran, J. E. Tcheng, J. J. Griffin, G. Guagliumi, et al.
Impact of anemia in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention: Analysis from the controlled abciximab and device investigation to lower late angioplasty complications (cadillac) trial
J. Am. Coll. Cardiol.,
August 4, 2004;
44(3):
547 - 553.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. G. Shlipak, G. L. Smith, S. S. Rathore, B. M. Massie, and H. M. Krumholz
Renal Function, Digoxin Therapy, and Heart Failure Outcomes: Evidence from the Digoxin Intervention Group Trial
J. Am. Soc. Nephrol.,
August 1, 2004;
15(8):
2195 - 2203.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. S. McKechnie, D. Smith, C. Montoye, E. Kline-Rogers, M. J. O'Donnell, A. C. DeFranco, W. L. Meengs, R. McNamara, J. G. McGinnity, K. Patel, et al.
Prognostic Implication of Anemia on In-Hospital Outcomes After Percutaneous Coronary Intervention
Circulation,
July 20, 2004;
110(3):
271 - 277.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. Anand, J. J.V. McMurray, J. Whitmore, M. Warren, A. Pham, M. A. McCamish, and P. B.J. Burton
Anemia and Its Relationship to Clinical Outcome in Heart Failure
Circulation,
July 13, 2004;
110(2):
149 - 154.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. van der Meer, A. A. Voors, E. Lipsic, T. D. J. Smilde, W. H. van Gilst, and D. J. van Veldhuisen
Prognostic value of plasma erythropoietin on mortality in patients with chronic heart failure
J. Am. Coll. Cardiol.,
July 7, 2004;
44(1):
63 - 67.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. R. Wessel, C. B. Arant, and C. J. Pepine
Commentary on "New and Emerging Theories of Cardiovascular Disease"
Biol Res Nurs,
July 1, 2004;
6(1):
17 - 20.
[PDF]
|
|
|
|
|
|
|
R. Sharma, D. P Francis, B. Pitt, P. A Poole-Wilson, A. J.S Coats, and S. D Anker
Haemoglobin predicts survival in patients with chronic heart failure: a substudy of the ELITE II trial
Eur. Heart J.,
June 2, 2004;
25(12):
1021 - 1028.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. B. Arant, T. R. Wessel, M. B. Olson, C. N. Bairey Merz, G. Sopko, W. J. Rogers, B. L. Sharaf, S. E. Reis, K. M. Smith, B. D. Johnson, et al.
Hemoglobin level is an independent predictor for adverse cardiovascular outcomes in women undergoing evaluation for chest pain: Results from the National Heart, Lung, and Blood Institute women's ischemia syndrome evaluation study
J. Am. Coll. Cardiol.,
June 2, 2004;
43(11):
2009 - 2014.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. H. Shuhaiber
Intraoperative hematocrit and cardiopulmonary bypass
J. Thorac. Cardiovasc. Surg.,
April 1, 2004;
127(4):
1226 - 1227.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. van der Meer, A. A. Voors, E. Lipsic, W. H. van Gilst, and D. J. van Veldhuisen
Erythropoietin in cardiovascular diseases
Eur. Heart J.,
February 2, 2004;
25(4):
285 - 291.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. K. Eltzschig, R. Ehlers, S. K. Shernan, W. Rodriguez, S. M. Silver, D. Schoevaerdts, C. Swine, D. Vanpee, M. Jessup, and S. Brozena
Heart Failure
N. Engl. J. Med.,
September 4, 2003;
349(10):
1002 - 1004.
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. J Smith, A. J Bleyer, W. C Little, and D. C Sane
The cardiovascular effects of erythropoietin
Cardiovasc Res,
September 1, 2003;
59(3):
538 - 548.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Schroecksnadel, B. Wirleitner, D. Fuchs, W. Steinborn, P. Ponikowski, S. Anker, P. van der Meer, W. H. van Gilst, D. J. van Veldhuisen, J. Ezekowitz, et al.
Anemia and Congestive Heart Failure * Response
Circulation,
August 12, 2003;
108
(6):
e41 - e42.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Not, E. Faleschini, A. Tommasini, A. Repetto, M. Pasotti, V. Baldas, A. Spano, D. Sblattero, R. Marzari, C. Campana, et al.
Celiac disease in patients with sporadic and inherited cardiomyopathies and in their relatives
Eur. Heart J.,
August 1, 2003;
24(15):
1455 - 1461.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Mozaffarian, R. Nye, and W. C. Levy
Anemia predicts mortality in severe heart failure: The prospective randomized amlodipine survival evaluation (PRAISE)
J. Am. Coll. Cardiol.,
June 4, 2003;
41(11):
1933 - 1939.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Silverberg
Outcomes of anaemia management in renal insufficiency and cardiac disease
Nephrol. Dial. Transplant.,
June 1, 2003;
18(suppl_2):
ii7 - ii12.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. C. Thomas, R. J. MacIsaac, C. Tsalamandris, D. Power, and G. Jerums
Unrecognized Anemia in Patients With Diabetes: A cross-sectional survey
Diabetes Care,
April 1, 2003;
26(4):
1164 - 1169.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A. Ezekowitz, F. A. McAlister, and P. W. Armstrong
Anemia Is Common in Heart Failure and Is Associated With Poor Outcomes: Insights From a Cohort of 12 065 Patients With New-Onset Heart Failure
Circulation,
January 21, 2003;
107(2):
223 - 225.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A.-S. Androne, S. D. Katz, L. Lund, J. LaManca, A. Hudaihed, K. Hryniewicz, and D. M. Mancini
Hemodilution Is Common in Patients With Advanced Heart Failure
Circulation,
January 21, 2003;
107(2):
226 - 229.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. S. Silverberg, D. Wexler, M. Blum, J. Z. Tchebiner, D. Sheps, G. Keren, D. Schwartz, R. Baruch, T. Yachnin, M. Shaked, et al.
The effect of correction of anaemia in diabetics and non-diabetics with severe resistant congestive heart failure and chronic renal failure by subcutaneous erythropoietin and intravenous iron
Nephrol. Dial. Transplant.,
January 1, 2003;
18(1):
141 - 146.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. K. Ghali
Anemia and poor prognosis in advanced heart failure
J. Am. Coll. Cardiol.,
December 18, 2002;
40(12):
2204 - 2204.
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. C. Fonarow, T. B. Horwich, M. A. Hamilton, and W. R. MacLellan
Reply
J. Am. Coll. Cardiol.,
December 18, 2002;
40(12):
2204 - 2204.
[Full Text]
[PDF]
|
|
|
|
Top
Abstract
Methods
