Noda Eri, Matsushima Shouji, Hashimoto Toru, Tsutsui Yoshitomo, Misumi Kayo, Enzan Nobuyuki, Yoshida Keimei, Shinohara Keisuke, Fujino Takeo, Katsuki Shunsuke, Sakamoto Takafumi, Hosokawa Kazuya, Kinugawa Shintaro, Abe Kohtaro
Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-Ku, Fukuoka, Fukuoka, 812-8582, Japan.
Sci Rep. 2025 Jan 31;15(1):3918. doi: 10.1038/s41598-025-87650-z.
Moderate/severe anemia [hemoglobin (Hb) < 10 g/dL] is recommended to be treated in patients with renal anemia. However, the optimal therapeutic target for Hb levels in patients with heart failure (HF) is unknown. This study aimed to investigate the impact of severity of anemia, especially moderate/severe anemia, associated with renal dysfunction (RD: eGFR < 60 mL/min/1.73 m) in HF patients. We analyzed 1,608 HF patients from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) database. Patients were classified based on the severity of admission anemia in the presence/absence of RD. Patients with RD and anemia were older, more likely to be female, and had a history of HF admission. The composite outcome was higher in RD and moderate/severe anemia (adjusted hazard ratio:2.120, 95% CI:1.559-2.881, p < 0.001) compared to RD and non/mild anemia (Hb ≥ 10 g/dL), non-RD and moderate/severe anemia, and non-RD and non/mild anemia (reference). During hospitalization, 6% and 10% of patients had improving and worsening RD and/or moderate/severe anemia, respectively. These status changes were associated with the post-discharge outcomes in HF patients. Moderate/severe anemia has a prognostic impact in HF patients with RD and may be an appropriate therapeutic target in HF.
建议对肾性贫血患者进行中度/重度贫血（血红蛋白（Hb）<10 g/dL）治疗。然而，心力衰竭（HF）患者血红蛋白水平的最佳治疗目标尚不清楚。本研究旨在调查与肾功能不全（RD：估算肾小球滤过率（eGFR）<60 mL/min/1.73 m²）相关的贫血严重程度，尤其是中度/重度贫血对HF患者的影响。我们分析了来自日本心脏病学会心力衰竭注册数据库（JCARE-CARD）的1608例HF患者。根据入院时有无RD的贫血严重程度对患者进行分类。患有RD和贫血的患者年龄更大，女性可能性更高，且有HF住院史。与RD和非/轻度贫血（Hb≥10 g/dL）、非RD和中度/重度贫血以及非RD和非/轻度贫血（参照组）相比，RD和中度/重度贫血患者的复合结局更高（校正风险比：2.120，95%置信区间：1.559-2.881，p<0.001）。住院期间，分别有6%和10%的患者出现RD和/或中度/重度贫血改善和恶化。这些状态变化与HF患者出院后的结局相关。中度/重度贫血对患有RD的HF患者有预后影响，可能是HF的一个合适治疗目标。
