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Abstract: Poster Presentations |

PREVALENCE AND IMPACT OF ANEMIA ON SURVIVAL IN INDIGENT SYSTOLIC HEART FAILURE PATIENTS RECEIVING STANDARD MEDICAL THERAPY FREE TO VIEW

Lee M. Arcement, MD*; Ron Horswell, PhD; Richy Lee, PharmD; Kathy Hebert, MD
Author and Funding Information

Chabert Medical Center, Houma, LA


Chest


Chest. 2005;128(4_MeetingAbstracts):292S. doi:10.1378/chest.128.4_MeetingAbstracts.292S-a
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Abstract

PURPOSE:  Previous studies have shown an association between anemia and mortality in patients with heart failure. One question not addressed is the anemia-mortality relationship within a heart failure population enrolled in a disease management program receiving standard medical therapy including Ace inhibitors and beta blocker medications. Also, the independant effect of anemia on survival has not been well described in a rural indigent population.

METHODS:  The sample included 328 patients with EF ≤ 40% who enrolled in a heart failure disease management program from 1999 to 2003 in rural South Louisiana. Our database was reviewed and a proportional hazards survival model was estimated. Anemia was defined as a hemoglobin of <12g/dl in females and <13 g/dl in males. Terms considered for inclusion into the model were gender, African-American race, age, ejection fraction (< 25% vs. 25-40%), QRS duration, NYHA class (III/IV vs I/II), use of beta blockers, and use of ACE inhibitors.

RESULTS:  The prevalence of anemia in this group was 29%. The final model included age (HR=1.04, p=.023), ejection fraction < 25% (HR=2.71, p=.002), African-American race (HR = 1.21, p=.576), and anemia (HR= 2.55, p=.002, 95% CI 1.40 - 4.67). The median annual income was $ 11,300 for both cohorts.

CONCLUSION:  Anemia is common in this cohort. Anemia is strongly associated with mortality in a younger rural indigent heart failure population, even when patients are enrolled in a disease management program receiving both Ace inhibitors and beta blockers.

CLINICAL IMPLICATIONS:  Identifying this high risk subgroup is important and treating anemia may be considered. Ascertaining the impact of treating anemia in this subgroup must be undertaken in future clinical trials.

DISCLOSURE:  Lee Arcement, None.

Wednesday, November 2, 2005

12:30 PM - 2:00 PM


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