Predictive Value Of Hemoglobin Concentration On Vulnerable-phase Prognosis For Discharged Patients With Preserved Ejection Fraction Heart Failure

Objective:To explore the predictive value of hemoglobin concentration on vulnerable-phase prognosis for hospitalized patients with preserved ejection fraction heart failure.Methods: a total of 98 consecutive hospitalized HFp EF patients were included between May 2017 and May 2018,hemoglobin concentration was measured in 24 hours and the relative clinical information was collected.These patients were followed up in vulnerable phase,and the combined endpoint was all-cause death or heart failure rehospitalization.Through receiver operating characteristic analyses according to the association of hemoglobin concentration and combined endpoint,the cut point was Hb=13.1g/d L,and the included patients were separated into two groups,group A Hb<13.1g/d L and group B Hb?13.1g/d L,according to the cut point.Results: Compared with group B,the proportion of female,class of NYHA cardiac function[?-?],and the concentration of brain natriuretic peptide,D-dimer,serum creatinine,blood urea nitrogen and the utilization rate of furosemide were higher in group A,but the hematocrit and the concentration of albumin were lower in group A.After the vulnerable phase followed-up,the rate of combined endpoints(Avs B33.3%vs15.1%,P=0.034)and heart failure rehospitalization risk(Avs B26.7%vs9.4%,P=0.025)were higher in group A.the all-cause mortality was no difference between two groups.After adjusted multiple varieties,Cox regression analysis indicated that baseline Hb concentration was an independent predictor of combined endpoint(HR 0.963,95%CI 0.939-0.987;P=0.003)and heart failure rehospitalization risk(HR 0.945,95%CI 0.971-0.973;P<0.001),and for every 1-g/d L-higher baseline Hb,the rate of combined endpoint and heart failurerehospitalization risk was 3.7% and 5.5% lower over the vulnerable phase respectively,There was no significant difference between Hb concentrations and all-cause mortality,no matter univariable and multivariable analysis.Conclusions: For HFpEF patients in vulnerable phase,the hemoglobin concentration was an independent predictor for combined endpoints andheart failure rehospitalization risk in this stage.