Clinical Implications of Anemia in Heart Failure (HF) Patients (pts).

Previous studies have shown that anemia is frequently associated with higher morbidity and mortality in HF pts. Our aim was to determine the impact of anemia in pts hospitalized with congestive HF at our hospital. We analyzed data from 277 pts with diagnosis of HF admitted between 1 June 2004 and 31 December 2005, with a follow up of at least 6 months. Anemia was defined as hemoglobin (Hb) <11,5 g/dl. HF was classified according to Framingham criteria. Previous history of arterial hypertension, diabetes, dislipemia, chronic renal insufficiency and ACE inhibitors treatment was recorded. Ischaemic and non- ischaemic etiology of cardiopathy was established. Renal disfunction was defined as creatinin concentraction >1.9 mg/dl. Pts with HF were assigned to group A (with anemia) or B (control). Statistical analysis was performed using Pearson’s Chi square, Spearman’s rho, Fisher test and Kaplan Meyer survival function.

Results: We evaluated 229 (82,7%) pts with a median follow up of 594 days (range: 1–1129 days). Mean age was 68,02 years (median 71, range: 17–91). 143/229 (62,4%) were male. In 75 /229 (32.75%) cases a Hb < 11,5 g/dl was measured at admission. The mean Hb was 13,1 g/dl for the entire group. Anemia pts showed a mean Hb of 10.6 g/dl. Demographic, clinical and outcome features are shown in table 1.Group A showed a higher number of readmissions because of HF and other cardiac.

Conclussions: In our analysis the prevalence of anemia was 33% in pts hospitalized for HF. There was no significant differences among clinical variables between anemic and non-anemic pts. Anemia was associated with worse clinical outcome (Group A pts required more readmissions for HF and other cardiological causes)and all cause mortality. Mean survival was longer in Group B pts.according to Kaplan Meyer analysis.

TABLE 1:

RESULTS

.	GROUP A (n=75) .	GROUP B (n= 154) .	p .
Male	42 (56%)	101 (65.5%)
Mean age (years)	70.38 (R:20–90)	67.1 (R:17–91)
Mean Hb (g/dl)	10.6	14.3
Ischaemic cardiopathy	38(50,6%)	78(50.6%)
Non ischaemic cardiopathy	41(54,6%)	78
Arterial hypertension	54(72%)	106(68.8%)
Diabetes	24(32%)	33(21.4%)
Dislipaemia	35(46.6%)	64(41.5%)
Chronic renal insufficiency	18(24%)	19(12.3%)	0.03
Previous ACE inhibitors treatment	25(33%)	71(46%)	0.08
Acute pulmonary edema	12(16%)	15(9.7%)
Creatinin concentration > 1.9 mg/dl	16(21.3%)	18 (11.6%)
Hospitalization days (mean)	9.6 (R: 1–51)	8.1(R:1–59)
Readmission for HF	37	190	0.001
Readmission for other cardiologic causes	20	109	0.017
Readmission for non cardiologic diseases	18	58
Mean survival (days)	499 (R:1–1091)	658 (r=1–1129)	0.166
Global mortality	25 (33%)	32(21%)	0.05
HF related mortality	13 (20.9%)	24 (14.3%)

.	GROUP A (n=75) .	GROUP B (n= 154) .	p .
Male	42 (56%)	101 (65.5%)
Mean age (years)	70.38 (R:20–90)	67.1 (R:17–91)
Mean Hb (g/dl)	10.6	14.3
Ischaemic cardiopathy	38(50,6%)	78(50.6%)
Non ischaemic cardiopathy	41(54,6%)	78
Arterial hypertension	54(72%)	106(68.8%)
Diabetes	24(32%)	33(21.4%)
Dislipaemia	35(46.6%)	64(41.5%)
Chronic renal insufficiency	18(24%)	19(12.3%)	0.03
Previous ACE inhibitors treatment	25(33%)	71(46%)	0.08
Acute pulmonary edema	12(16%)	15(9.7%)
Creatinin concentration > 1.9 mg/dl	16(21.3%)	18 (11.6%)
Hospitalization days (mean)	9.6 (R: 1–51)	8.1(R:1–59)
Readmission for HF	37	190	0.001
Readmission for other cardiologic causes	20	109	0.017
Readmission for non cardiologic diseases	18	58
Mean survival (days)	499 (R:1–1091)	658 (r=1–1129)	0.166
Global mortality	25 (33%)	32(21%)	0.05
HF related mortality	13 (20.9%)	24 (14.3%)

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