Heart failure & cardiomyopathiesMeta-analysis
Low-Normal Hemoglobin Concentrations and Clinical Outcomes in Heart Failure
- Pooled patient-level analysis of randomised trials
- sex-specific analysis
- Cox proportional hazards models
- Poisson regression with restricted cubic splines
Authors' conclusion
In patients with HF, hemoglobin concentrations associated with the lowest risk of death and HF hospitalization were approximately 14 g/dL in women and 15 g/dL in men.
Study context
- Population
- Patients with heart failure (HF) across the spectrum of LVEF (heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF)/heart failure with mildly reduced ejection fraction (HFmrEF))6 HFrEF + 5 HFpEF/HFmrEF trials
- Comparison
- Hemoglobin categories relative to World Health Organization (WHO) anemia thresholds
- Outcome
- First HF hospitalization or CV death (also its components and all-cause death)
Pooled result
As reported in the abstract
Hemoglobin with lowest risk
Lowest risk in women, across HF phenotypes and outcomes
approximately 14 g/dL
Lowest risk in men, across HF phenotypes and outcomes
15 g/dL
Further pooled results
| Outcome | Values |
|---|---|
| Baseline hemoglobin, HFrEF (n = 25,003: 5,581 women, 19,422 men) | Women median 13.0 (IQR 12.1–13.9) g/dL · Men median 14.0 (IQR 12.9–15.1) g/dL |
| Baseline hemoglobin, HFpEF/HFmrEF (n = 17,210: 8,763 women, 8,447 men) | Women median 13.1 (IQR 12.1–14.0) g/dL · Men median 14.0 (IQR 12.8–15.0) g/dL |
Original publication
Low-Normal Hemoglobin Concentrations and Clinical Outcomes in Heart Failure. J Am Coll Cardiol. Published 28 August 2026. doi:10.1016/j.jacc.2026.08.013
Summarised from the published abstract; every number is checked against it