Significance of anaemia in patients with advanced heart failure receiving long‐term mechanical circulatory support

Aims The aim of this study was to analyse the prognostic impact of anaemia in patients receiving long‐term left ventricular assist device (LVAD) support. Methods and results We reviewed the data of 65 consecutive patients who underwent LVAD support for at least 6 months. Anaemia was defined as haemoglobin levels <12.0 g/dL. Follow‐up was performed 15 months after implantation. Anaemia was present in 30/65 patients (46%) after 6 months of LVAD support. Anaemic patients had higher levels of pre‐implant creatinine (1.8 ± 0.8 vs. 1.4 ± 0.5 mg/dL; P = 0.04). The presence of anaemia after 6 months correlated with higher levels of creatinine and blood urea nitrogen and lower levels of albumin. Multivariate Cox proportional hazards regression analysis revealed that levels of haemoglobin <12 g/dL [risk ratio (RR), 8.94; 95% confidence interval (CI), 1.09–73.01; P = 0.04], creatinine >1.4 mg/dL (RR, 5.39; 95% CI, 1.78–16.30; P = 0.003), and albumin <1.5 g/L (RR, 3.23; 95% CI, 1.10–9.51; P = 0.03) were associated with all‐cause mortality at 15 months. Long‐term survival evaluated by Kaplan–Meier analysis was two times higher in non‐anaemic patients after 6 months of LVAD support than in anaemic patients ( P = 0.01). Conclusion Anaemia is related to adverse outcomes in patients receiving prolonged LVAD support.