Mean corpuscular haemoglobin concentration and outcomes in heart failure with preserved ejection fraction
Abstract Aims This study aims to evaluate the prognostic value of mean corpuscular haemoglobin concentration (MCHC) on clinical outcomes in patients with heart failure with preserved ejection fraction (HFpEF). Methods and results We analysed HFpEF participants from the Americas in the Treatment of P...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-04-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.14225 |
| _version_ | 1797857596631154688 |
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| author | Manting Choy Zhe Zhen Bin Dong Cong Chen Yugang Dong Chen Liu Weihao Liang Ruicong Xue |
| author_facet | Manting Choy Zhe Zhen Bin Dong Cong Chen Yugang Dong Chen Liu Weihao Liang Ruicong Xue |
| author_sort | Manting Choy |
| collection | DOAJ |
| description | Abstract Aims This study aims to evaluate the prognostic value of mean corpuscular haemoglobin concentration (MCHC) on clinical outcomes in patients with heart failure with preserved ejection fraction (HFpEF). Methods and results We analysed HFpEF participants from the Americas in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial with available baseline data (n = 1747). Patients were grouped into hypochromia or non‐hypochromia group according to a MCHC cut‐off level of 330 g/L. Cox proportional hazard model was used to explore the prognostic value of hypochromia on the long‐term clinical outcomes (the primary endpoint [composite of cardiovascular mortality, HF hospitalization and aborted cardiac arrest], any‐cause and HF hospitalization, all‐cause and cardiovascular mortality). Patients were further stratified according to baseline estimated glomerular filtration rate (eGFR) to explore the impact of renal dysfunction on the prognostic value of hypochromia. Baseline hypochromia was prevalent (n = 662, 37.9%) and strongly associated with worse clinical outcomes. In patients with worse renal function (eGFR < 60 mL/min per 1.73 m2), hypochromia was independently associated with primary endpoint (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.23–1.98; P < 0.001), any‐cause hospitalization (HR, 1.43; 95% CI, 1.20–1.71, P < 0.001) and HF hospitalization (HR, 1.40; 95% CI, 1.07–1.84; P = 0.015), whereas no significant association between hypochromia and these outcomes was found in patients with better renal function. Conclusions Among HFpEF patients, hypochromia (i.e. MCHC ≤ 330 g/L) is independently associated with adverse clinical outcomes, especially when in the presence of co‐morbidity renal dysfunction. |
| first_indexed | 2024-04-09T20:59:18Z |
| format | Article |
| id | doaj.art-1130394cd7d542d4a2bd0dc2785773ed |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-04-09T20:59:18Z |
| publishDate | 2023-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-1130394cd7d542d4a2bd0dc2785773ed2023-03-29T11:45:21ZengWileyESC Heart Failure2055-58222023-04-011021214122110.1002/ehf2.14225Mean corpuscular haemoglobin concentration and outcomes in heart failure with preserved ejection fractionManting Choy0Zhe Zhen1Bin Dong2Cong Chen3Yugang Dong4Chen Liu5Weihao Liang6Ruicong Xue7Department of Cardiology The First Affiliated Hospital of Sun Yat‐sen University Guangzhou ChinaDepartment of Cardiology The First Affiliated Hospital of Sun Yat‐sen University Guangzhou ChinaDepartment of Cardiology The First Affiliated Hospital of Sun Yat‐sen University Guangzhou ChinaDivision of Cardiology, Department of Medicine The University of Hong Kong Shenzhen Hospital Shenzhen ChinaDepartment of Cardiology The First Affiliated Hospital of Sun Yat‐sen University Guangzhou ChinaDepartment of Cardiology The First Affiliated Hospital of Sun Yat‐sen University Guangzhou ChinaDepartment of Cardiology The First Affiliated Hospital of Sun Yat‐sen University Guangzhou ChinaDepartment of Cardiology The First Affiliated Hospital of Sun Yat‐sen University Guangzhou ChinaAbstract Aims This study aims to evaluate the prognostic value of mean corpuscular haemoglobin concentration (MCHC) on clinical outcomes in patients with heart failure with preserved ejection fraction (HFpEF). Methods and results We analysed HFpEF participants from the Americas in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial with available baseline data (n = 1747). Patients were grouped into hypochromia or non‐hypochromia group according to a MCHC cut‐off level of 330 g/L. Cox proportional hazard model was used to explore the prognostic value of hypochromia on the long‐term clinical outcomes (the primary endpoint [composite of cardiovascular mortality, HF hospitalization and aborted cardiac arrest], any‐cause and HF hospitalization, all‐cause and cardiovascular mortality). Patients were further stratified according to baseline estimated glomerular filtration rate (eGFR) to explore the impact of renal dysfunction on the prognostic value of hypochromia. Baseline hypochromia was prevalent (n = 662, 37.9%) and strongly associated with worse clinical outcomes. In patients with worse renal function (eGFR < 60 mL/min per 1.73 m2), hypochromia was independently associated with primary endpoint (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.23–1.98; P < 0.001), any‐cause hospitalization (HR, 1.43; 95% CI, 1.20–1.71, P < 0.001) and HF hospitalization (HR, 1.40; 95% CI, 1.07–1.84; P = 0.015), whereas no significant association between hypochromia and these outcomes was found in patients with better renal function. Conclusions Among HFpEF patients, hypochromia (i.e. MCHC ≤ 330 g/L) is independently associated with adverse clinical outcomes, especially when in the presence of co‐morbidity renal dysfunction.https://doi.org/10.1002/ehf2.14225Mean corpuscular haemoglobin concentrationHeart failure with preserved ejection fractionRenal dysfunctionPrognosis |
| spellingShingle | Manting Choy Zhe Zhen Bin Dong Cong Chen Yugang Dong Chen Liu Weihao Liang Ruicong Xue Mean corpuscular haemoglobin concentration and outcomes in heart failure with preserved ejection fraction ESC Heart Failure Mean corpuscular haemoglobin concentration Heart failure with preserved ejection fraction Renal dysfunction Prognosis |
| title | Mean corpuscular haemoglobin concentration and outcomes in heart failure with preserved ejection fraction |
| title_full | Mean corpuscular haemoglobin concentration and outcomes in heart failure with preserved ejection fraction |
| title_fullStr | Mean corpuscular haemoglobin concentration and outcomes in heart failure with preserved ejection fraction |
| title_full_unstemmed | Mean corpuscular haemoglobin concentration and outcomes in heart failure with preserved ejection fraction |
| title_short | Mean corpuscular haemoglobin concentration and outcomes in heart failure with preserved ejection fraction |
| title_sort | mean corpuscular haemoglobin concentration and outcomes in heart failure with preserved ejection fraction |
| topic | Mean corpuscular haemoglobin concentration Heart failure with preserved ejection fraction Renal dysfunction Prognosis |
| url | https://doi.org/10.1002/ehf2.14225 |
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