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Does Left Ventricular Assist Device Lead to Anemia in Heart Failure Patients? A Meta-Analysis

Kaiyun Gu, Bin Gao, Yu Chang, Zheng Zhuo, Yi Zeng

Med Sci Tech 2015; 56:84-90

DOI: 10.12659/MST.895790

Available online: 2015-10-14

Published: 2015-10-14


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BACKGROUND: Anemia is a prevalent complication in heart failure patients, which relates to poor prognosis. Left ventricular assist device (LVADs), as an important therapy for heart failure, is confirmed to impair the structure and function of erythrocytes, which may aggravate the degree of anemia. However, the precise effect of LVADs on anemia in clinical practice is unclear. Hence, we conducted a meta-analysis to clarify the effect of left ventricular assist devices (LVADs) on anemia in patients with heart failure.
MATERIAL AND METHODS: Relevant studies through August 2014 were searched and identified in Medline, Cochrane Library, Web of Science, and Science Direct online databases. Studies that reported standard mean difference estimates with 95% confidence intervals (CIs) for the associations of interest were included. Data were extracted and summary estimates of associations were obtained using the inverse-variance fixed-effects model.
RESULTS: Of the 7 studies included, 2 studies evaluated anemia in patients with advanced heart failure receiving long-term mechanical circulatory support. Five studies estimated the hemoglobin in patients with left ventricular assist device (LVADs) support. The standard mean differences of LVADs were 0.05(95% CI: –0.03 to 0.12; p=0.23) for hemoglobin, –0.65 (95% CI: –0.79 to –0.51; p<0.00001) for BUN, and –0.39(95% CI: –0.53 to –0.26; p<0.00001) for creatinine. The standard mean differences of anemia with LVADs support were –0.11(95% CI: –0.46 to 0.24; p=0.54) for hemoglobin, –0.24 (95% CI: –0.59 to 0.12; p=0.19) for blood urea nitrogen (BUN), and –0.06(95% CI: –0.41 to 0.29; p=0.73) for creatinine.
CONCLUSIONS: There is no statistical difference in the effect of LVADs on hemoglobin between pre- and pro-implantation LVADs. In contrast, the implantation of LVADs is confirmed to improve the state of BUN and creatinine for heart failure patients; LVADs have a similar effect on the change of hemoglobin for anemia and no-anemia patients. The effects of LVADs on BUN and creatinine for patients with and without anemia were not significantly different. The differences in the effects of LVADs on hemoglobin, BUN, and creatinine of patients could provide useful information for establishing clinical strategies.

Keywords: Anemia, Meta-Analysis as Topic



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