Effect of anemia and CKD on prognosis of heart failure with preserved ejection fraction in advanced elderly
10.3969/j.issn.1009-0126.2023.10.006
- VernacularTitle:贫血和慢性肾脏病对高龄老年射血分数保留的心力衰竭患者预后影响的研究
- Author:
Qingying ZHU
1
;
Xiaoyan QIN
;
Gechu SHANG
;
Yan GAO
Author Information
1. 261053 潍坊医学院中医学院
- Keywords:
anemia;
nephrosis;
heart failure;
prognosis;
risk factors;
regression analysis
- From:Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2023;25(10):1029-1033
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the impact of anemia and chronic kidney disease(CKD)on the prognosis of elderly patients with HFpEF.Methods A retrospective cohort study was conducted on 224 very old patients(age ≥80 years)with HFpEF admitted to Department of General Medi-cine of No.960 Hospital of PLA Joint Logistics Support Force from January 2016 to March 2023.According to their estimated glomerular filtration rate(eGFR)and hemoglobin level at admis-sion,they were divided into non-CKD+non-anemia group(88 cases),CKD group(14 cases),ane-mia group(79 cases)and CKD+anemic group(43 cases).The patients in the anemic group were further divided into mild(67 cases)and moderate-to-severe anemia subgroups(12 cases),and those of the CKD+anemia group were divided into CKD+mild anemia subgroup(31 cases)and CKD+moderate anemia subgroup(12 cases).The endpoints of follow-up included all-cause death,cardiovascular death and the end of follow-up.The relationships of CKD and anemia with progno-sis in elderly HFpEF patients were analyzed.Results During the follow-up period,all-cause mor-tality occurred in 100 patients(44.6％)and cardiovascular death in 32 patients(14.3％).Kaplan-Meier survival curve analysis showed that the CKD+anemia group had significantly higher rates of all-cause and cardiovascular death than the non-CKD+non-anemia,CKD and anemia groups(P＜0.01).Cox regression analysis indicated that the risk of all-cause mortality and cardiovascu-lar mortality was significantly higher in the CKD+moderate anemia subgroup than the non-CKD+non-anemia group(HR=6.43,95％CI:2.82-14.68,P=0.000;HR=10.63,95％CI:2.17-51.95,P=0.004).The risk of cardiovascular death was obviously higher in the moderate-to-severe anemia subgroup than in the non-CKD+non-anemia group(HR=4.96,95％CI:1.19-20.72,P=0.028).Conclusion Moderate-to-severe anemia is an independent risk factor for cardiovascular death in elderly HFpEF patients,and CKD complicated with moderate anemia significantly increa-ses the risk of all-cause mortality and cardiovascular death in elderly HFpEF patients.
