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.

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.