Deleterious impact of mild anemia on survival of young adult patients (age 45 ± 14 years) with idiopathic dilated cardiomyopathy: Data from the Trieste Cardiomyopathies Registry

Abstract Objective The study objective was to evaluate the impact of anemia on a large population of young patients with idiopathic dilated cardiomyopathy (DCM) who were receiving optimal medical treatment. Methods The data of 491 patients with DCM who were enlisted in the Trieste Heart Muscle Disease Registry were analyzed. Anemia was defined as hemoglobin less than 13 g/dL for male patients and less than 12 g/dL for female patients. Results At baseline, 13% of our patients were anemic. During the follow-up of 134 ± 56 months, 144 patients died or underwent heart transplantation: 36.5% anemic patients and 28% non-anemic patients ( P  = .05). Anemia present at baseline was an independent predictor of outcome (hazard ratio = 1.85, P = .014). Serial hemoglobin determinations during the entire follow-up were available in 122 of 428 patients without anemia at baseline. The impact of new-onset anemia was analyzed in this cohort of patients. Forty-seven patients (39%) developed anemia during follow-up. The new onset of anemia was an independent predictor of poor outcome (hazard ratio = 2.85, P = .02). Conclusion The presence or development of mild anemia in young patients with optimally treated idiopathic DCM is frequent and associated with a worse outcome.