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Prognostic significance of hemoglobin level in patients with congestive heart failure and normal ejection fraction

Padmini Varadarajan1, Siddharth Gandhi, Sanjay Sharma

  • 1Department of Medicine, Loma Linda University Medical Center, Loma Linda, California, USA.

Clinical Cardiology
|October 27, 2006
PubMed

Insights

Low hemoglobin (Hb) independently worsens survival in patients with congestive heart failure (CHF), regardless of left ventricular ejection fraction (EF). This finding highlights Hb as a critical prognostic factor in CHF management.

Area of Science:

  • Cardiology
  • Hematology

Background:

  • Previous research indicates low hemoglobin (Hb) negatively impacts survival in congestive heart failure (CHF) patients with reduced left ventricular ejection fraction (EF).
  • The prognostic significance of low Hb in CHF patients with preserved EF remains largely uninvestigated.

Purpose of the Study:

  • To investigate the association between low Hb and survival in patients diagnosed with CHF and normal EF.
  • To determine if low Hb is an independent predictor of mortality in CHF patients across different EF statuses.

Main Methods:

  • A retrospective chart review of 2,246 CHF patients (48% with normal EF) diagnosed between 1990-1999.
  • Diagnosis validation using Framingham criteria and mortality data from the National Death Index.
  • Survival analysis conducted with Kaplan-Meier and Cox regression models, adjusting for multiple clinical variables.

Main Results:

  • Low Hb (< 12 gm/dl) was significantly associated with decreased 5-year survival in both normal EF (38% vs. 50%) and reduced EF (35% vs. 48%) groups.
  • Cox regression analysis identified low Hb as an independent predictor of mortality, even after adjusting for age, gender, renal dysfunction, diabetes, hypertension, and EF.

Conclusions:

  • Low hemoglobin exerts an independent adverse effect on survival in patients with congestive heart failure.
  • This adverse effect is consistent across patients with both normal and reduced left ventricular ejection fraction.
Abstract

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