PMID- 27126377
OWN - NLM
STAT- MEDLINE
DCOM- 20171031
LR  - 20180209
IS  - 1879-0844 (Electronic)
IS  - 1388-9842 (Linking)
VI  - 18
IP  - 7
DP  - 2016 Jul
TI  - Prognostic significance of endogenous erythropoietin in long-term outcome of
      patients with acute decompensated heart failure.
PG  - 803-13
LID - 10.1002/ejhf.537 [doi]
AB  - AIMS: Although previous reports suggest that an elevated endogenous
      erythropoietin (EPO) level is associated with worse clinical outcomes in chronic 
      heart failure (HF) patients, the prognostic implication of EPO in patients with
      acute decompensated HF (ADHF) and underlying mechanisms of the high EPO level in 
      severe HF patients who have a poor prognosis remain unclear. METHODS AND RESULTS:
      We examined 539 consecutive ADHF patients with EPO measurement on admission from 
      our registry. During a median follow-up period of 329 days, a higher EPO level on
      admission was independently associated with worse clinical outcomes [hazard ratio
      (HR) 1.25, 95% confidence interval (CI) 1.06-1.48, P = 0.008], and haemoglobin
      level was the strongest determinant of EPO level (P < 0.001), whereas estimated
      glomerular filtration rate (eGFR) was not significant in multivariate regression 
      analysis. In the anaemic subgroup of 318 patients, a higher EPO level than
      expected on the basis of their haemoglobin level was related to increased adverse
      events (HR 1.63, 95% CI 1.05-2.49, P = 0.028). Moreover, estimated plasma volume 
      excess rate was positively associated with EPO level (P = 0.003), and anaemic
      patients with a higher than expected EPO level tended to have a higher estimated 
      plasma volume excess rate and plasma lactate level, and lower systemic oxygen
      saturation level with the preservation of the reticulocyte production index than 
      those with a lower than expected EPO level. CONCLUSION: A high EPO level predicts
      long-term worse clinical outcomes in ADHF patients, independent of anaemia and
      impaired renal function. Anaemia and hypoxia due to severe congestion may
      synergistically contribute to a high EPO level in high-risk HF patients.
CI  - (c) 2016 The Authors. European Journal of Heart Failure (c) 2016 European Society
      of Cardiology.
FAU - Nagai, Toshiyuki
AU  - Nagai T
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular
      Center, Osaka, Japan.
FAU - Nishimura, Kunihiro
AU  - Nishimura K
AD  - Preventive Medicine and Epidemiology Informatics, National Cerebral and
      Cardiovascular Center, Osaka, Japan.
FAU - Honma, Takehiro
AU  - Honma T
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular
      Center, Osaka, Japan.
FAU - Higashiyama, Aya
AU  - Higashiyama A
AD  - Preventive Medicine and Epidemiology Informatics, National Cerebral and
      Cardiovascular Center, Osaka, Japan.
FAU - Sugano, Yasuo
AU  - Sugano Y
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular
      Center, Osaka, Japan.
FAU - Nakai, Michikazu
AU  - Nakai M
AD  - Preventive Medicine and Epidemiology Informatics, National Cerebral and
      Cardiovascular Center, Osaka, Japan.
FAU - Honda, Satoshi
AU  - Honda S
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular
      Center, Osaka, Japan.
FAU - Iwakami, Naotsugu
AU  - Iwakami N
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular
      Center, Osaka, Japan.
FAU - Okada, Atsushi
AU  - Okada A
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular
      Center, Osaka, Japan.
FAU - Kawakami, Shoji
AU  - Kawakami S
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular
      Center, Osaka, Japan.
FAU - Kanaya, Tomoaki
AU  - Kanaya T
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular
      Center, Osaka, Japan.
FAU - Asaumi, Yasuhide
AU  - Asaumi Y
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular
      Center, Osaka, Japan.
FAU - Aiba, Takeshi
AU  - Aiba T
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular
      Center, Osaka, Japan.
FAU - Nishida, Yoko
AU  - Nishida Y
AD  - Foundation for Biomedical Research and Innovation, Hyogo, Japan.
FAU - Kubota, Yoshimi
AU  - Kubota Y
AD  - Department of Environmental and Preventive Medicine, Hyogo College of Medicine,
      Hyogo, Japan.
FAU - Sugiyama, Daisuke
AU  - Sugiyama D
AD  - Department of Preventive Medicine and Public Health, Keio University, Tokyo,
      Japan.
FAU - Okamura, Tomonori
AU  - Okamura T
AD  - Department of Preventive Medicine and Public Health, Keio University, Tokyo,
      Japan.
FAU - Noguchi, Teruo
AU  - Noguchi T
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular
      Center, Osaka, Japan.
FAU - Kusano, Kengo
AU  - Kusano K
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular
      Center, Osaka, Japan.
FAU - Ogawa, Hisao
AU  - Ogawa H
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular
      Center, Osaka, Japan.
FAU - Yasuda, Satoshi
AU  - Yasuda S
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular
      Center, Osaka, Japan.
FAU - Anzai, Toshihisa
AU  - Anzai T
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular
      Center, Osaka, Japan.
CN  - NaDEF investigators
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20160429
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
RN  - 0 (EPO protein, human)
RN  - 0 (Hemoglobins)
RN  - 11096-26-7 (Erythropoietin)
RN  - 33X04XA5AT (Lactic Acid)
SB  - IM
MH  - Acute Disease
MH  - Aged
MH  - Aged, 80 and over
MH  - Anemia/*blood/complications
MH  - Cause of Death
MH  - Cohort Studies
MH  - Disease Progression
MH  - Erythropoietin/*blood
MH  - Female
MH  - Glomerular Filtration Rate
MH  - Heart Failure/*blood/complications
MH  - Hemoglobins/metabolism
MH  - Humans
MH  - Lactic Acid/blood
MH  - Male
MH  - Middle Aged
MH  - *Mortality
MH  - Multivariate Analysis
MH  - Oximetry
MH  - Plasma Volume
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Prospective Studies
MH  - *Registries
MH  - Renal Insufficiency/blood/complications
OTO - NOTNLM
OT  - *Acute heart failure
OT  - *Anaemia
OT  - *Biomarker
OT  - *Erythropoietin
OT  - *Prognosis
EDAT- 2016/04/30 06:00
MHDA- 2017/11/01 06:00
CRDT- 2016/04/30 06:00
PHST- 2015/10/26 00:00 [received]
PHST- 2016/02/28 00:00 [revised]
PHST- 2016/03/05 00:00 [accepted]
PHST- 2016/04/30 06:00 [entrez]
PHST- 2016/04/30 06:00 [pubmed]
PHST- 2017/11/01 06:00 [medline]
AID - 10.1002/ejhf.537 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2016 Jul;18(7):803-13. doi: 10.1002/ejhf.537. Epub 2016 Apr 29.