Abstract 13587: Hemoglobin Levels Can Predict Early Rehospitalization in Advanced Heart Failure Patients Listed for Heart Transplantation Without Inotropes or Mechanical Circulatory Support

Abstract

Background: Anemia is a common comorbidity which often coexists in patients with heart failure (HF), and is associated with poor clinical outcome. However, it is unclear whether hemoglobin value has clinical impact in advanced HF patients. Hypothesis: Hemoglobin value influence the clinical outcome of patients with advanced HF. Methods: We retrospectively reviewed clinical data of ambulatory advanced HF patients who were listed for heart transplantation at our institute without intravenous inotropes or mechanical circulatory support (MCS) between 2011 and 2022. We divided the patients with a hemoglobin of lower or higher than the median value, and compared a composite of all-cause death and rehospitalization for HF within 1 year. Results: We enrolled consecutive 38 HF patients (28 males, 49±11 years old). All patients had New York Heart Association III or IV symptoms. The median hemoglobin value at the time of listing for heart transplantation was 12.9 g/dL, 42% met the criteria of anemia, and 67% had iron deficiency. Patients in the lower hemoglobin group were characterized by lower body mass index (19.7±3.0 vs. 21.7±3.1 kg/m 2 , P=0.049), lower systolic blood pressure (84.0±7.6 vs. 88.9±6.2 mmHg, P=0.034) and lower albumin (4.0±0.4 vs. 4.3±0.3 g/dL, P=0.031) than those in the higher hemoglobin group. Age, prevalence of male, left ventricular ejection fraction and brain natriuretic peptide were comparable between the two groups. No patient died in either group at 1 year. The HF rehospitalization-free survival rate was significantly lower in the lower hemoglobin group (41% vs. 82% at 1 year, P=0.020). By multivariate Cox regression analyses, hemoglobin as a continuous variable was an independent predictor for early HF rehospitalization (odds ratio 0.70, 95% confidence interval 0.49-0.97, P=0.030). Conclusion: Lower hemoglobin was a predictor of early HF rehospitalization in ambulatory advanced HF patients listed for heart transplantation without inotropes or MCS.