# Impact of Bicytopenia on Mortality in Hospitalised Patients With Heart Failure

## TL;DR

This study finds that bicytopenia is linked to higher overall mortality in hospitalized heart failure patients, but not specifically to heart-related deaths.

## Contribution

The study identifies bicytopenia as a novel risk factor for all-cause mortality in heart failure patients.

## Key findings

- Bicytopenia was associated with increased all-cause mortality in heart failure patients.
- Bicytopenia was not linked to higher cardiovascular mortality or hospital readmissions for heart failure.
- Propensity score matching confirmed the association between bicytopenia and all-cause mortality.

## Abstract

Limited data are available on bicytopenia (BC) in patients with heart failure (HF).

This study evaluated the association between BC and prognosis in patients with HF.

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.

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).

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.