Evidence map›Paper›PMID 30847487›Full record

ArticleEuropean heart journal. Quality of care & clinical outcomes2019

Incident anaemia in older adults with heart failure: rate, aetiology, and association with outcomes.

Andrew P Ambrosy, Jerry H Gurwitz, Grace H Tabada, Andrew Artz, Stanley Schrier, Sunil V Rao, Huiman X Barnhart, Kristi Reynolds, David H Smith, Pamela N Peterson and 4 more

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Article in European heart journal. Quality of care & clinical outcomes, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Observational
  3. Article
  4. Article
  5. Article
  6. Iron deficiency and short-term adverse events in patients with decompensated heart failure.Clinical research in cardiology : official journal of the German Cardiac Society · 2021
    Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Andrew P AmbrosyDepartment of Cardiology, Kaiser Permanente San Francisco Medical Center, San Francisco, CA, USA.
Jerry H GurwitzDivision of Geriatric Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
Grace H TabadaDivision of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, USA.
Andrew ArtzSection of Hematology/Oncology, The University of Chicago, Chicago, IL, USA.
Stanley SchrierDivision of Hematology, Stanford University School of Medicine, Stanford, CA, USA.
Sunil V RaoDivision of Cardiology, Duke University Medical Center, Durham, NC, USA.
Huiman X BarnhartDuke Clinical Research Institute, Duke University Medical School, Durham, NC, USA.
Kristi ReynoldsDepartment of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
David H SmithCenter for Health Research, Kaiser Permanente Northwest, Portland, OR, USA.
Pamela N PetersonInstitute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA.
Sue Hee SungDivision of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, USA.
Harvey Jay CohenCenter for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA.
Alan S GoDivision of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, USA.
RBC HEART Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsLimited data exist on the epidemiology, evaluation, and prognosis of otherwise unexplained anaemia of the elderly in heart failure (HF). Thus, we aimed to determine the incidence of anaemia, to characterize diagnostic testing patterns for potentially reversible causes of anaemia, and to evaluate the independent association between incident anaemia and long-term morbidity and mortality. METHODS AND

resultsWithin the Cardiovascular Research Network (CVRN), we identified adults age ≥65 years with diagnosed HF between 2005 and 2012 and no anaemia at entry. Incident anaemia was defined using World Health Organization (WHO) haemoglobin thresholds (<13.0 g/dL in men; <12.0 g/dL in women). All-cause death and hospitalizations for HF and any cause were identified from electronic health records. Among 38 826 older HF patients, 22 163 (57.1%) developed incident anaemia over a median (interquartile range) follow-up of 2.9 (1.2-5.6) years. The crude rate [95% confidence interval (CI)] per 100 person-years of incident anaemia was 26.4 (95% CI 26.0-26.7) and was higher for preserved ejection fraction (EF) [29.2 (95% CI 28.6-29.8)] compared with borderline EF [26.5 (95% CI 25.4-27.7)] or reduced EF [26.6 (95% CI 25.8-27.4)]. Iron indices, vitamin B12 level, and thyroid testing were performed in 20.9%, 14.9%, and 40.2% of patients, respectively. Reduced iron stores, vitamin B12 deficiency, and/or hypothyroidism were present in 29.7%, 3.2%, and 18.6% of tested patients, respectively. In multivariable analyses, incident anaemia was associated with excess mortality [hazard ratio (HR) 2.14, 95% CI 2.07-2.22] as well as hospitalization for HF (HR 1.80, 95% CI 1.72-1.88) and any cause (HR 1.77, 95% CI 1.72-1.83).

conclusionAmong older adults with HF, incident anaemia is common and independently associated with substantially increased risks of morbidity and mortality. Additional research is necessary to clarify the value of routine evaluation and treatment of potentially reversible causes of anaemia.

Indexed as

AgedAged, 80 and overAnemiaCohort StudiesFemaleHeart FailureHumansIncidenceMaleAnaemiaEjection fractionHeart failureIron deficiencyOutcomes

Identifiers

PMID30847487
PMCPMC6775859

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.