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Title: Prevalence, clinical correlates, and outcomes of anaemia in multi-ethnic asian patients with heart failure with reduced ejection fraction
Authors: Vera J. Goh
Jasper Tromp
Tiew Hwa K. Teng
Wan Ting Tay
Peter Van Der Meer
Lieng Hsi Ling
Bambang B. Siswanto
Chung Lieh Hung
Wataru Shimizu
Shu Zhang
Calambur Narasimhan
Cheuk Man Yu
Sang Weon Park
Tachapong Ngarmukos
Houng Bang Liew
Eugenio Reyes
Jonathan Yap
Michael Macdonald
Mark A. Richards
Inder Anand
Carolyn S.P. Lam
National University Health System
Duke-NUS Medical School Singapore
Manila Doctors Hospital
Care Hospital Hyderabad
Universitas Indonesia
Mackay Memorial Hospital Taiwan
Nippon Medical School
Singapore General Hospital
University of Otago
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
VA Medical Center
Changi General Hospital
University of Groningen, University Medical Center Groningen
National Heart Centre, Singapore
Chinese University of Hong Kong
Queen Elizabeth Hospital
Sejong General Hospital
Fuwai Cardiovascular Hospital
Keywords: Medicine
Issue Date: 1-Aug-2018
Citation: ESC Heart Failure. Vol.5, No.4 (2018), 570-578
Abstract: © 2018 The Authors. Aims Recent international heart failure (HF) guidelines recognize anaemia as an important comorbidity contributing to poor outcomes in HF, based on data mainly from Western populations. We sought to determine the prevalence, clinical correlates, and prognostic impact of anaemia in patients with HF with reduced ejection fraction across Asia. Methods and results We prospectively studied 3886 Asian patients (60 ± 13 years, 21% women) with HF (ejection fraction ≤40%) from 11 regions in the Asian Sudden Cardiac Death in Heart Failure study. Anaemia was defined as haemoglobin <13 g/dL (men) and <12 g/dL (women). Ethnic groups included Chinese (33.0%), Indian (26.2%), Malay (15.1%), Japanese/Korean (20.2%), and others (5.6%). Overall, anaemia was present in 41%, with a wide range across ethnicities (33–54%). Indian ethnicity, older age, diabetes, and chronic kidney disease were independently associated with higher odds of anaemia (all P < 0.001). Ethnicity modified the association of chronic kidney disease with anaemia (Pinteraction = 0.045), with the highest adjusted odds among Japanese/Koreans [2.86; 95% confidence interval (CI) 1.96–4.20]. Anaemic patients had lower Kansas City Cardiomyopathy Questionnaire scores (P < 0.001) and higher risk of all-cause mortality and HF hospitalization at 1 year (hazard ratio = 1.28, 95% CI 1.08–1.50) compared with non-anaemic patients. The prognostic impact of anaemia was modified by ethnicity (Pinteraction = 0.02), with the greatest hazard ratio in Japanese/Koreans (1.82; 95% CI 1.14–2.91). Conclusions Anaemia is present in a third to more than half of Asian patients with HF and adversely impacts quality of life and survival. Ethnic differences exist wherein prevalence is highest among Indians, and survival is most severely impacted by anaemia in Japanese/Koreans.
ISSN: 20555822
Appears in Collections:Scopus 2018

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