Prospective assessment of the occurrence of anemia in patients with heart failure: results from the Study of Anemia in a Heart Failure Population (STAMINA-HFP) Registry.

BACKGROUND: Although a potentially important pathophysiologic factor in heart failure, the prevalence and predictors of anemia have not been well studied in unselected patients with heart failure. METHODS: The Study of Anemia in a Heart Failure Population (STAMINA-HFP) Registry prospectively studied the prevalence of anemia and the relationship of hemoglobin to health-related quality of life and outcomes among patients with heart failure. A random selection algorithm was used to reduce bias during enrollment of patients seen in specialty clinics or clinics of community cardiologists with experience in heart failure. In this initial report, data on prevalence and correlates of anemia were analyzed in 1,076 of the 1,082 registry patients who had clinical characteristics and hemoglobin determined by finger-stick at baseline. RESULTS: Overall (n = 1,082), the registry patients were 41% female and 73% white with a mean age (+/-SD) of 64 +/- 14 years (68 +/- 13 years in community and 57 +/- 14 years in specialty sites, P < .001). Among the 1,076 patients in the prevalence analysis, mean hemoglobin was 13.3 +/- 2.1 g/dL (median 13.2 g/dL); and anemia (defined by World Health Organization criteria) was present in 34%. Age identified patients at risk for anemia, with 40% of patients >70 years affected. CONCLUSIONS: Initial results from the STAMINA-HFP Registry suggest that anemia is a common comorbidity in unselected outpatients with heart failure. Given the strong association of anemia with adverse outcomes in heart failure, this study supports further investigation concerning the importance of anemia as a therapeutic target in this condition.

Relations among early postexposure noise-induced threshold shifts and permanent threshold shifts in the chinchilla.

Threshold shifts (TS) were measured at various times following a wide variety of noise exposures on over 900 chinchillas. An analysis of postexposure TS measures and noise-induced permanent threshold shift (PTS) showed that, across audiometric test frequency, there was a consistent relation between these variables of the form PTS (dB) = alpha(e(TS/beta) - 1), where, for a given test frequency, alpha (dB) and beta (dB) are constants. TSs were measured immediately following exposure (TS0), 24 h after exposure (TS24), and at several intermediate times in order to estimate the maximum TS (TSmax). Correlation between TS and PTS at the various test frequencies was highest for TS24. An analysis of the 90th-percentile PTS showed a linear growth of PTS with TS24 of approximately 0.7 dB PTS/dB TS24. These data provide some support, in the chinchilla model, for a variation of the three postulates originally presented by Kryter et al. [J. Acoust. Soc. Am. 39, 451 (1966)]. Specifically: (i) TS24 is a consistent measure of the effects of a traumatic noise exposure. (ii) All exposures that produce a given TS24 will be equally hazardous. (iii) Noise-induced PTS in the most susceptible animals, following many years of exposure, is approximately equal to (0.7)TS24 measured after an 8-h exposure to the same noise.