Impact of Bicytopenia on Mortality in Hospitalised Patients With Heart Failure

Background: Limited data are available on bicytopenia (BC) in patients with heart failure (HF). Objectives: This study evaluated the association between BC and prognosis in patients with HF. Methods: This retrospective cohort study enrolled consecutive hospitalised patients with HF. We compared all-cause and cardiovascular mortality between those with and without BC. BC was defined as the combination of any two conditions among leukopaenia, thrombocytopaenia, and anaemia. Propensity score matching and a Cox proportional hazards model were applied. Results: Among 935 hospitalised patients, 103 patients had BC. Patients in the BC group were older (80.0 ± 12.0 vs. 73.4 ± 14.7 years; P < 0.0001), including a higher proportion of females (55.3% vs. 41.7%; P = 0.009), had a higher prevalence of atrial fibrillation (51.5% vs 41.1%; P = 0.047), had a lower baseline estimated glomerular filtration rate (50.8 ± 24.1 vs. 56.2 ± 23.9 mL/min/1.73 m2; P = 0.03), and had a higher left ventricular ejection fraction (48.1 ± 16.1 vs. 42.4 ± 15.8%; P = 0.0008). Propensity score matching with a 1:1 ratio produced 63 matched pairs. All-cause mortality was significantly higher in the BC group than in the non-BC group (log-rank P = 0.069 and Wilcoxon P = 0.048); however, cardiovascular mortality and hospitalisation for HF showed no significant differences. In the multivariate Cox proportional hazard model, BC was associated with higher all-cause mortality but not with cardiovascular mortality (hazard ratio, 1.983; 95% confidence interval, 1.008–3.898; P = 0.047). Conclusion: BC was associated with all-cause mortality but not with cardiovascular mortality in patients with HF. BC is an important risk factor for all-cause mortality in patients with HF.