Anemia and hemoglobin thresholds of 12.5 and 13.0 g/dL are associated with distinct cardiovascular and all-cause mortality risks in COPD.

Authors

Yan Wang, Yushan Shi

Published in

International journal of cardiology. Cardiovascular risk and prevention. Volume 30. Pages 200691. Epub Aug 07, 2026.

Abstract

Anemia is a prevalent comorbidity in chronic obstructive pulmonary disease (COPD), yet prior studies have predominantly focused on all-cause mortality, leaving the non-linear relationship between hemoglobin and mortality-and clinically actionable thresholds-undefined. We aimed to identify distinct hemoglobin thresholds associated with cardiovascular and all-cause mortality and evaluate hemoglobin as a prognostic risk indicator in COPD.
This prospective cohort study utilized data from seven NHANES cycles (2005-2018), including 1338 U S. adults with COPD representing approximately 7.7 million non-institutionalized COPD patients. Weighted Cox proportional hazards models and restricted cubic spline analysis were conducted to explore the association between hemoglobin level and mortality in COPD.
The weighted prevalence of anemia among U.S. adults with COPD was 10.5%. Anemia was significantly associated with all-cause mortality (HR = 2.32, 95% CI: 1.85-2.92) and cardiovascular mortality (HR = 3.75, 95% CI: 2.06-6.83). Each 1 g/dL hemoglobin increment was associated with 17% and 22% risk reductions, respectively. RCS analysis identified nonlinear relationships with thresholds at 12.5 g/dL for all-cause and 13.0 g/dL for cardiovascular mortality. Findings remained robust across all sensitivity analyses.
Anemia and lower hemoglobin levels were independently associated with significantly increased risks of all-cause and cardiovascular mortality. Hemoglobin thresholds of 12.5 g/dL and 13.0 g/dL were identified for all-cause and cardiovascular mortality, respectively, as prognostic indicators warranting further validation. These findings underscore the importance of hemoglobin assessment in risk stratification; however, interventional studies are needed to determine whether correction of anemia improves survival in this population.

PMID:
42604085
Bibliographic data and abstract were imported from PubMed on 16 Aug 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.