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Sci Rep. 2019 Feb 13;9(1):1924. doi: 10.1038/s41598-018-36066-z.

Anemia in Patients with Severe Aortic Stenosis.

Author information

1
Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan.
2
Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
3
Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan.
4
Department of Cardiology, Kokura Memorial Hospital, Kokura, Japan.
5
Division of Cardiology, Shimada Municipal Hospital, Shimada, Japan.
6
Department of Cardiology, Shizuoka City Shizuoka Hospital, Shizuoka, Japan.
7
Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
8
Department of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, Japan.
9
Department of Cardiology, Tenri Hospital, Tenri, Japan.
10
Division of Cardiology, Nara Hospital, Kinki University Faculty of Medicine, Ikoma, Japan.
11
Department of Cardiology, Mitsubishi Kyoto Hospital, Kyoto, Japan.
12
Department of Cardiology, Kinki University Hospital, Osakasayama, Japan.
13
Department of Cardiology, Koto Memorial Hospital, Higashiomi, Japan.
14
Department of Cardiology, Shizuoka General Hospital, Shizuoka, Japan.
15
Department of Cardiology, Nishikobe Medical Center, Kobe, Japan.
16
Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.
17
Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
18
Cardiovascular Center, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan.
19
Department of Cardiology, Hikone Municipal Hospital, Hikone, Japan.
20
Department of Cardiology, Kansai Electric Power Hospital, Osaka, Japan.
21
Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan.
22
Department of Cardiology, Japanese Red Cross Otsu Hospital, Otsu, Japan.
23
Department of Cardiology, Saiseikai Noe Hospital, Osaka, Japan.
24
Department of Cardiology, Shiga Medical Center for Adults, Moriyama, Japan.
25
Department of Cardiology, Hamamatsu Rosai Hospital, Hamamatsu, Japan.
26
Department of Cardiology, Hirakata Kohsai Hospital, Hirakata, Japan.
27
Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
28
Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. taketaka@kuhp.kyoto-u.ac.jp.

Abstract

Prognostic impact of anemia complicating severe aortic stenosis (AS) remains unclear. We assessed the impact of anemia on cardiovascular and bleeding outcomes in 3403 patients enrolled in the CURRENT AS registry. 835 patients (25%) had mild (hemoglobin 11.0-12.9 g/dl for men/11.0-11.9 g/dl for women) and 1282 patients (38%) had moderate/severe anemia (Hb ≤ 10.9 g/dl) at diagnosis of severe AS. Mild and moderate/severe anemia were associated with significantly increased risks relative to no anemia (hemoglobin ≥13.0 g/dl for men/≥12.0 g/dl for women) for the primary outcome measure (aortic valve-related death or heart failure hospitalization) in the entire population [hazard ratio (HR): 1.30; 95% confidence interval (CI): 1.07-1.57 and HR: 1.56; 95%CI: 1.31-1.87, respectively] and in the conservative management stratum (HR: 1.73; 95%CI: 1.40-2.13 and HR: 2.05; 95%CI: 1.69-2.47, respectively). Even in the initial aortic valve replacement stratum, moderate/severe anemia was associated with significantly increased risk for the primary outcome measure (HR: 2.12; 95%CI: 1.44-3.11). Moreover, moderate/severe anemia was associated with significantly increased risk for major bleeding while under conservative management (HR: 1.93; 95%CI: 1.21-3.06). These results warrant further study to explore whether better management of anemia would lead to improvement of clinical outcomes.

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