Abstract 14878: Relationship of Serum Erythropoietin Level to Clinical Outcome in Acute Heart Failure Patients Without Anemia

BACKGROUND: Elevation of serum erythropoietin (EPO) level is frequently observed in heart failure (HF) patients, and higher serum EPO level has been reported to be associated with worse clinical outcome in chronic HF. However, serum EPO level was highly influenced by the presence of anemia and its prognostic significance in acute HF (AHF) patients without anemia remains unknown. METHODS: We examined 320 consecutive AHF patients who admitted to our institution between January 2013 and January 2014 from prospective registry. Patients who had anemia defined as a hemoglobin concentration < 13g/dl (males) and <12 g/dl (females) based on the WHO criteria, acute coronary syndrome and without complete data-set at admission were excluded. Finally, 92 patients were divided into two groups according to higher serum EPO level (above 25.7 mIU/ml, the median) or lower serum EPO level (below 25.7 mIU/ml) at admission. Adverse events were defined as worsening HF and death within 90 days after admission. RESULTS: Adverse events were occurred in 10 patients (11 %). Higher EPO group had significantly higher incidence of adverse events compared with lower EPO group (19.6% vs 10.9%, P<0.01, Figure). Patients with higher EPO level had higher serum creatinine and plasma brain natriuretic peptide (BNP) levels on admission than those without. There were no significant differences between the two groups in terms of age, gender, oxygen saturation, NYHA class, cardiovascular medications, left ventricular ejection fraction (LVEF), reticulocyte count on admission. Multivariate logistic regression analyses showed that higher serum EPO level (OR 10.6, 95% CI 1.7-204.9, P<0.01) was an independent determinant for adverse events within 90 days after admission, among variables including age, gender, LVEF, serum creatinine, hemoglobin and plasma BNP levels on admission. CONCLUSIONS: Higher serum EPO level might be a predictor for worse short-term clinical outcome in AHF patients without anemia.