Hemoconcentration is a good prognostic predictor for clinical outcomes in acute heart failure: Data from the Korean Heart Failure (KorHF) Registry

• Published in: International journal of cardiology 2013-10, Vol.168 (5), p.4739-4743
• Main Authors: Oh, Jaewon, Kang, Seok-Min, Hong, Namki, Youn, Jong-Chan, Han, Seongwoo, Jeon, Eun-Seok, Cho, Myeong-Chan, Kim, Jae-Joong, Yoo, Byung-Su, Chae, Shung Chull, Oh, Byung-Hee, Choi, Dong-Ju, Lee, Myung-Mook, Ryu, Kyu-Hyung
• Format: Article
• Language: English
• Subjects: Acute Disease; Acute heart failure; Aged; Biological and medical sciences; Biomarkers - blood; Cardiology. Vascular system; Cardiovascular; Cause of Death - trends; Diuretics - therapeutic use; Female; Follow-Up Studies; Heart; Heart Failure - blood; Heart Failure - drug therapy; Heart Failure - mortality; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Hematocrit; Hemoconcentration; Hemoglobins - metabolism; Humans; Male; Medical sciences; Patient Readmission - trends; Prognosis; Proportional Hazards Models; Prospective Studies; Registries; Republic of Korea - epidemiology; Survival Rate - trends; Time Factors
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2013.07.241

Abstract Background Hemoconcentration is a surrogate marker of effective decongestion and diuresis therapy. Recently, hemoconcentration has been associated with decreased mortality and rehospitalization in heart failure (HF) patients. However, the prognostic power of hemoconcentration in a large sample-sized HF cohort was limited until now. Methods and results We analyzed data from hospitalized patients with acute heart failure (AHF) that were enrolled in the Korean Heart Failure Registry( n = 2,357). The primary end point was a composite of all-cause mortality and HF rehospitalization during the follow-up period (median = 347, interquartile range = 78–744 days).Hemoconcentration, defined as an increased hemoglobin level between admission and discharge, was presented in 1,016 AHF patients (43.1%). In multivariable logistic regression, hemoglobin, total cholesterol, and serum glucose levels at admission, and ischemic HF, were significant determinants for hemoconcentration occurrence. The Kaplan–Meier curve showed that event-free survival was significantly higher in the hemoconcentration group compared to the non-hemoconcentration group (65.1% vs. 58.1%, log rank p < 0.001). In multiple Cox proportional hazard analysis, hemoconcentration was an independent predictor of the primary end point after adjusting for other HF risk factors (hazard ratio = 0.671, 95% confidence interval = 0.564–0.798, p < 0.001). Conclusions Hemoconcentration during hospitalization was a prognostic marker of fewer clinical events in the AHF cohort. Therefore, this novel surrogate marker will help in the risk stratification of AHF patients.