Presence and impact of anemia in patients supported with left ventricular assist devices

作者全名："Tie, Hongtao; Li, Tong; Huang, Bi; Mariani, Silvia; Li, Tian; van Bussel, Bas C. T.; Wu, Qingchen; Pei, Jianqiu; Welp, Henryk; Martens, Sabrina; Li, Zhenhan; Shi, Rui; Zhu, Jing; Luo, Suxin; Lichtenberg, Artur; Aubin, Hug; Boeken, Udo; Lorusso, Roberto; Chen, Dan"

作者地址："[Tie, Hongtao; Wu, Qingchen; Chen, Dan] Chongqing Med Univ, Affiliated Hosp 1, Dept Cardiothorac Surg, Chongqing, Peoples R China; [Li, Tong; Lichtenberg, Artur; Aubin, Hug; Boeken, Udo] Heinrich Heine Univ, Med Sch, Dept Cardiac Surg, Dusseldorf, Germany; [Huang, Bi; Luo, Suxin] Chongqing Med Univ, Affiliated Hosp 1, Dept Cardiol, Chongqing, Peoples R China; [Mariani, Silvia; Lorusso, Roberto] Maastricht Univ, Med Ctr, Heart & Vasc Ctr, Cardiothorac Surg Dept, Maastricht, Netherlands; [Li, Tian] Univ Freiburg, Med Ctr, Fac Med, Dept Cardiol & Angiol, Freiburg, Germany; [van Bussel, Bas C. T.] Maastricht Univ, Cardiovasc Res Inst Maastricht CARIM, Dept Intens Care Med, Maastricht, Netherlands; [van Bussel, Bas C. T.] Maastricht Univ, Care & Publ Hlth Res Inst CAPHRI, Maastricht, Netherlands; [Pei, Jianqiu] Capital Med Univ, Sch Basic Med Sci, Dept Biochem & Mol Biol, Beijing, Peoples R China; [Welp, Henryk; Martens, Sabrina] Univ Hosp Muenster, Dept Cardiothorac Surg, Munster, Germany; [Li, Zhenhan] Chongqing Tradit Chinese Med Hosp, Dept Endocrinol, Chongqing, Peoples R China; [Shi, Rui] Univ Paris Saclay, Hop Bicetre, AP HP, Serv Medecine Intens Reanimat, Le Kremlin Bicetre, France; [Zhu, Jing] Chongqing Med Univ, Affiliated Hosp 1, Dept Oncol, Chongqing, Peoples R China; [Chen, Dan] Chongqing Med Univ, Affiliated Hosp 1, Dept Cardiothorac Surg, Chongqing 400016, Peoples R China"

通信作者："Lorusso, R (通讯作者)，Maastricht Univ, Med Ctr, Heart & Vasc Ctr, Cardiothorac Surg Dept, Maastricht, Netherlands.; Chen, D (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Cardiothorac Surg, Chongqing 400016, Peoples R China."

来源：JOURNAL OF HEART AND LUNG TRANSPLANTATION

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001059423100001

JCR分区：Q1

影响因子：6.4

年份：2023

卷号：42

期号：9

开始页：1261

结束页：1274

文献类型：Article

关键词：left ventricular assist device; anemia; INTERMACS registry

摘要："BACKGROUND: Data on anemia and its effects on patients supported with continuous-flow left ven-tricular assist devices (LVADs) are lacking.OBJECTIVES: This study sought to describe the presence of anemia over time and investigate its as-sociation with mortality, quality of life, exercise capacity, and adverse events in LVAD patients. METHODS: Adults receiving durable LVADs between 2008 and 2017 were identified from the INT-ERMACS database. The full cohort was stratified according to anemia severity (no anemia, mild, and moderate-severe).RESULTS: The analysis of 19,509 patients (females: 21.2%, age: 56.9 & PLUSMN; 12.9 years) showed that moderate-severe anemia affected 45.2% of patients at baseline, 33.5% of them at 6 months, and 32.3% in the fourth year after implantation. The presence of normal hemoglobin was 24.4% before surgery, 32.5% at 6 months, and 36.6% at 4 years after implantation. Multivariable linear mixed-effect regression revealed that the average hemoglobin over time was significantly lower (& beta;, -0.233, 95% confidence interval (CI): -0.282 to -0.185), and the reduction of hemoglobin over time was bigger (& beta;, -0.032 95% CI: -0.035 to -0.028) for LVAD nonsurvivors compared with LVAD survivors. Adjusted Cox regression showed that the severity of preimplant anemia was associated with higher mortality (HR, mild: 1.19; 95% CI: 1.05-1.35 and moderate-severe: 1.44; 95% CI: 1.28-1.62), with similar results in competing risk regression. Anemia progression during follow-up was associated with decreased Kansas City Cardiomyopathy Questionnaire scores and shorter 6-minute walk distances. CONCLUSIONS: In patients supported with LVADs, anemia is a frequent comorbidity, and deterioration over time is associated with poor prognosis.& COPY; 2023 International Society for Heart and Lung Transplantation. All rights reserved."

基金机构："National Natural Science Foundation of China [CYYY-BSHPYXM-2022-08]; First-class Discipline Construction Project of First Clinical College, Chongqing Medical University [CSTB2022NSCQ-MSX0840]; Natural Science Foundation of Chongqing, China [W0153]; CQMU Program for Youth Innovation in Future Medicine [ZYRC2022-04]; First Affiliated Hospital of CQMU Young Outstanding Scientific and Technological Talents Program [2023-56]; Senior Medical Talents Program of Chongqing for Young and Middle-aged; [81700602]"

基金资助正文："This work was supported by the National Natural Science Foundation of China (No. 81700602) , the First-class Discipline Construction Project of First Clinical College, Chongqing Medical University (No. CYYY-BSHPYXM-2022-08) , the Natural Science Foundation of Chongqing, China (No. CSTB2022NSCQ-MSX0840) , the CQMU Program for Youth Innovation in Future Medicine (W0153) , the First Affiliated Hospital of CQMU Young Outstanding Scientific and Technological Talents Program~ (ZYRC2022-04) , and the Senior Medical Talents Program of Chongqing for Young and Middle-aged (2023-56) ."