Association of anemia and long-term survival in patients with pulmonary hypertension.

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2011-08-04

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Abstract

BACKGROUND: Anemia is a marker of worsened clinical outcome in patients with heart failure from left ventricular dysfunction. Pulmonary hypertension often results in right ventricular dysfunction. Accordingly we sought to examine the association of hemoglobin levels and long-term all-cause mortality in a cohort of patients with pulmonary hypertension. METHODS: Baseline demographic information, clinical characteristics and fasting blood work were obtained in a cohort of 145 patients with pulmonary hypertension referred for pulmonary vasodilator testing. Data was retrospectively analyzed with Cox-proportional hazards analysis. RESULTS: Baseline characteristics of the cohort included age (mean±SD) 55.8±14.6 years, 75% women, 50% with idiopathic pulmonary hypertension, mean pulmonary artery pressure 46.1±14.2 mm Hg and arterial O(2) saturation 91±6 %. The most commonly utilized pulmonary hypertension specific therapeutic agents in descending order of frequency were epoprostenol (27%), sildenafil (21%), bosentan (17%), and treprostinil (6%). Over a median follow-up of 2.1 years, there were 39 deaths (26.9%). Patients who died had significantly lower hemoglobin levels than those survived (12.2±2.3 vs. 13.7±2.0, p<0.001). After adjustment for known predictors of death and pulmonary hypertension etiology, anemic patients were 3.3 times more likely to die than non-anemic patients (95% CI [1.43-7.51], p=0.005). CONCLUSIONS: Hemoglobin levels closely parallel survival in pulmonary hypertension. Modification of anemia in this disorder could alter the clinical course and calls for further research in this area.

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10.1016/j.ijcard.2010.04.038

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Krasuski, Richard A, Stephen A Hart, Brad Smith, Andrew Wang, J Kevin Harrison and Thomas M Bashore (2011). Association of anemia and long-term survival in patients with pulmonary hypertension. Int J Cardiol, 150(3). pp. 291–295. 10.1016/j.ijcard.2010.04.038 Retrieved from https://hdl.handle.net/10161/11027.

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Scholars@Duke

Krasuski

Richard Andrew Krasuski

Professor of Medicine

Dr. Richard Krasuski is Director of the Adult Congenital Heart Center at Duke University Medical Center, the Director of Hemodynamic Research, and the Medical Director of the CTEPH Program. He is considered a thought leader in the fields of pulmonary hypertension and congenital heart disease. His research focus is in epidemiologic and clinical studies involving patients with pulmonary hypertension and patients with congenital heart disease. He is involved in multiple multicenter studies through the Alliance for Adult Research in Congenital Cardiology (AARCC). He has also helped to develop multiple research databases in these patient populations. He is Co-PI in the upcoming EPIPHANY Study examining the impact of medical and transcatheter interventions on RV-PA coupling in patients with chronic thromboembolic pulmonary hypertension. Over his career he has mentored over 80 students, residents and fellows and has published over 300 peer reviewed publications, book chapters and meeting abstracts. He is also the Chief Editor of Advances in Pulmonary Hypertension and on the editorial boards of several leading medical journals.

Wang

Andrew Wang

Professor of Medicine

Structural heart diseases, including valvular heart disease, hemodynamics, infective endocarditis, and hypertrophic cardiomyopathy

Harrison

John Kevin Harrison

Professor of Medicine
Bashore

Thomas Michael Bashore

Professor Emeritus of Medicine

The major areas of research involve mostly hemodynamic and imaging research:
1. Valvular heart disease.
2. Adult congenital heart disease.
3. Pulmonary Hypertension.
4. Complex cardiovascular problems.

The Valvular Disease Program and Adult Congenital Program are nationally recognized, and many trainees have gone on to academic careers at a number of universities. Dr. Bashore is now or recently has been on the Editorial Boards of Circulation, the American Journal of Cardiology, Cardiac Catheterization and Intervention, the Journal of Heart Valve Disease, the American Heart Journal, Cardiology Today, the Journal of Invasive Cardiology and the Journal of the American College of Cardiology. He was formerly director of the Diagnostic Cardiac Catheterization Laboratories for 10 years, and then the Director of the Cardiology Fellowship Training Program for 12 years. He is currently the Clinical Chief of the Division of Cardiology. He is a member and/or chairman of numerous committees of the American College of Cardiology and author of over 250 manuscripts, over 70 book chapters and reviews and 3 books. Dr. J. Kevin Harrison, Dr. Andrew Wang, Dr. Tom Gehrig, Dr. Todd Kiefer, Dr. Michael Sketch and Dr. Cary Ward complement the research team along with a variety of research personnel. Currently research is focused on the percutaneous treatment of structural heart disease and adult congenital heart disease.


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