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European Journal of Heart Failure 2009 11(10):1000-1004; doi:10.1093/eurjhf/hfp110
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

Significance of anaemia in patients with advanced heart failure receiving long-term mechanical circulatory support

Bojan Vrtovec1{dagger}, Rajko Radovancevic1, Reynolds M. Delgado1, Branislav Radovancevic1,{maltese cross}, Arthur W. Bracey2, Igor D. Gregoric1 and O.H. Frazier1,*

1 Center for Cardiac Support, Texas Heart Institute at St Luke's Episcopal Hospital, PO Box 20345, MC 3-147, Houston, TX 77225-0345, USA
2 Department of Pathology, Texas Heart Institute at St Luke's Episcopal Hospital, Houston, TX, USA

* Corresponding author. Tel: +1 832 355 3000, Fax: +1 832 355 6798, Email: lschwenke{at}heart.thi.tmc.edu or atodensky{at}heart.thi.tmc.edu


  Abstract

Aims: The aim of this study was to analyse the prognostic impact of anaemia in patients receiving long-term left ventricular assist device (LVAD) support.

Methods and results: We reviewed the data of 65 consecutive patients who underwent LVAD support for at least 6 months. Anaemia was defined as haemoglobin levels <12.0 g/dL. Follow-up was performed 15 months after implantation. Anaemia was present in 30/65 patients (46%) after 6 months of LVAD support. Anaemic patients had higher levels of pre-implant creatinine (1.8 ± 0.8 vs. 1.4 ± 0.5 mg/dL; P = 0.04). The presence of anaemia after 6 months correlated with higher levels of creatinine and blood urea nitrogen and lower levels of albumin. Multivariate Cox proportional hazards regression analysis revealed that levels of haemoglobin <12 g/dL [risk ratio (RR), 8.94; 95% confidence interval (CI), 1.09–73.01; P = 0.04], creatinine >1.4 mg/dL (RR, 5.39; 95% CI, 1.78–16.30; P = 0.003), and albumin <1.5 g/L (RR, 3.23; 95% CI, 1.10–9.51; P = 0.03) were associated with all-cause mortality at 15 months. Long-term survival evaluated by Kaplan–Meier analysis was two times higher in non-anaemic patients after 6 months of LVAD support than in anaemic patients (P = 0.01).

Conclusion: Anaemia is related to adverse outcomes in patients receiving prolonged LVAD support.

Key Words: Left ventricular assist device (LVAD) • Anaemia • Survival

Received February 5, 2009; Revised July 9, 2009; Accepted July 16, 2009

{dagger} Dr. Vrtovec is currently at the Department of Cardiology, Advanced Heart Failure and Transplantation Center, University Medical Center, Ljubljana, Slovenia.

{maltese cross} In memoriam.


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