Anemia nos pacientes com insuficiência cardíaca avançada

Cardoso, Juliano; Brito, Michel Ibrahim; Ochiai, Marcelo Eidi; Novaes, Milena; Berganin, Fabrício; Thicon, Tatiana; Ferreira, Elaine Cristina S.; Kelly, Regis B.; Reis, Caio Luiz Bitencourt; Barretto, Antônio Carlos Pereira

doi:10.1590/s0066-782x2010005000118

Cited by 9 publications

(9 citation statements)

References 25 publications

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“…(9) Factors such as anemia and impaired renal function are currently recognized as predictors of poor long-term prognosis in patients with severe heart failure. (17) Data on the occurrence of unplanned hospitalizations in the last year are in line with the results of another study, in which the authors claim that hospitalization due to acute heart failure generates more hospitalizations, with rates of readmissions up to 50% within 12 months after discharge. (3) Most patients reported notifying the doctor or nurse about signs of decompensation, with breathlessness being most important, followed by edema and weight gain.…”

Section: Resultssupporting

confidence: 76%

Ações de autocuidado em portadores de insuficiência cardíaca

Nascimento

Püschel

2013

Acta paul. enferm.

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Objective: Identify self-care actions of patients with heart failure in two settings: the emergency and outpatient care units, and to identify the main precipitating factors of heart decompensation. Methods: Cross-sectional study including 120 patients with heart failure in two settings, emergency and outpatient care units. Three validated instruments were used. Results: There was no statistically significant difference between the self-care groups, with low scores on weight control, vaccination and communication. Most of the study population was elderly, retired, with Chagas disease, and patients from the emergency care unit had the worst levels of urea, creatinine and hemoglobin. Conclusion: The patients practice self-care when they perceive aggravation in their clinical conditions and communication, weight control and vaccination, with no difference between the groups. Heart failure in emergency room patients may be associated with sociodemographic factors and characteristics of severity, including hemodynamic profile related to prolonged hospitalization and high mortality. ResumoObjetivo: Identificar as ações de autocuidado em portadores de insuficiência cardíaca em dois cenários: no pronto socorro e no ambulatório e identificar os principais fatores precipitantes de descompensação. Métodos: Estudo transversal no qual foram incluídos 120 portadores de insuficiência cardíaca em dois cenários: ambulatório e pronto socorro. Foram utilizados três instrumentos validados. Resultados: Não houve diferença estatisticamente significativa do autocuidado entre os grupos, com baixa pontuação sobre o controle de peso, vacinação e comunicação. A maioria da população de estudo era de idosos, aposentados, com doença de Chagas e, no grupo do pronto socorro tivemos os piores níveis de ureia, creatinina e hemoglobina. Conclusão: Os pacientes praticam o autocuidado na percepção de piora clínica e comunicação; controle de peso e vacinação, sem diferença entre os grupos. A descompensação nos pacientes do pronto socorro pode estar associada a fatores sociodemográficos e características de gravidade, incluindo o perfil hemodinâmico, relacionado à prolongada internação e alta letalidade.

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Section: Resultssupporting

confidence: 76%

Ações de autocuidado em portadores de insuficiência cardíaca

Nascimento

Püschel

2013

Acta paul. enferm.

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“…With a simple test, oral iron absorption test we can differentiate iron deficiency anemia from the anemia of chronic disease. The concentration of serum ferritin <100 ng/ml and transferrin saturation <20% may identify iron deficiency anemia (25). Weiss and Goudnough reported that transferrin saturation <16% and ferritin levels <30 ng/ml in the presence of inflammation and anemia may diagnose iron deficiency anemia.…”

Section: The Diagnosis Of Anemiamentioning

confidence: 99%

“…In a Spanish study of 99 patients with HF and anemia who needed hospitalization, only anemia was shown as a marker of poor prognosis. The higher incidence of anemia was found in patients needing hospitalization than the outpatients, and anemia was thought to be a marker of more severe disease (25). Kosiborod et al (34) in National Heart Project trial investigated the association between anemia and outcome in 50.405 patients with HF.…”

Section: Anemia and Outcomesmentioning

confidence: 99%

“…Thus, the effect of anemia on mortality is thought that anemia is a marker however; the effect of anemia on re-hospitalization, on quality of life, and on functional capacity is thought to be anemia's direct effect (31,34). The lower the hemoglobin values the higher the mortality (25). The longitudinal measurements of anemia are more important prognostic factors than basal measurements (35,36).…”

Section: Anemia and Outcomesmentioning

confidence: 99%

“…However, it has recently been known that every degree of anemia worsens the prognosis of HF. Anemia can be a reason for HF but it is also a consequence of HF (25). There are three ways of therapy: emergent therapy, iron replacement therapy and erythrocytosis stimulant agent (ESA).…”

Section: Therapy Optionsmentioning

confidence: 99%

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Anemia in heart failure

Kılıçgedik

Dündar²,

Tigen³

2012

Anadolu Kardiyol Derg

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Chronic heart failure is a common problem and a major cause of death, hospital admission, poor physical function and impaired quality of life. In addition to the direct effect of heart failure on prognosis, several modifiable and non-modifiable factors contribute to the worse prognosis in heart failure. Anemia, which is common in patients with heart failure, may represent a modifiable risk factor for adverse outcome. It is also a marker for co-morbidity burden and greater disease severity. If anemia is a marker, treatment may not obviate the increased risk associated with anemia, but if it is a mediator, treatment may be helpful to reduce morbidity and mortality in heart failure. As anemia has been identified as an independent prognostic factor of both morbidity and mortality for patients with congestive heart failure, there is an increased interest in the hypothesis that the correction of anemia with erythropoietin or iron supplementation might lead to an improvement on patients' symptoms and functional status. Large randomized trials are necessary to show the effect of anemia and the specific treatments on the outcome in these patients. This article reviews the mechanisms, impact on outcomes and therapy of anemia in patients with heart failure.

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Evaluation by N-terminal Prohormone of Brain Natriuretic Peptide Concentrations and Ross Scoring of the Efficacy of Digoxin in the Treatment of Heart Failure Secondary to Congenital Heart Disease With Left-to-Right Shunts

et al. 2013

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This study aimed to evaluate the effectiveness of digoxin in children with heart failure secondary to left-to-right shunt lesions and normal left ventricular systolic function. The study registered 37 such patients (ages 10 days to 24 months, groups 1 and 2) and used 20 healthy children as a control group (group 3). Left ventricular systolic function, as assessed by conventional echocardiography, was normal in all the subjects. Congestive heart failure was diagnosed by clinical evaluation and modified Ross scoring. Plasma N-terminal prohormone of brain natriuretic peptide (NT-proBNP) concentrations and complete blood counts were assessed in all the children. Group 1 was treated with digoxin, enalapril, and furosemide and group 2 with enalapril and furosemide. Approximately 1 month after starting treatment, the patients were reevaluated by physical and echocardiographic examinations, modified Ross scoring, plasma NT-proBNP concentrations, and complete blood counts. The pre- and posttreatment Ross scores of group 1 (p = 0.377) and group 2 (p = 0.616) did not differ significantly. The NT-proBNP values in both groups decreased after treatment (p = 0.0001). The pre- and posttreatment NT-proBNP values did not differ significantly in group 1 (p = 0.094)) and group 2 (p = 0.372). The pretreatment NT-proBNP values in groups 1 and 2 (p = 0.0001) were significantly higher than in the control group (p = 0.003). A smaller difference was observed between posttreatment NT-proBNP values in group 1 and the control group (p = 0.045). We found no significant difference between the posttreatment NT-proBNP values of group 2 and those of the control group (p = 0.271). The study showed that both treatments currently used to treat heart failure secondary to congenital heart disease with left-to-right shunts and preserved left ventricular systolic function are effective and do not differ significantly. Thus, digoxin does not provide any extra benefit in the treatment of such patients.

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Anemia nos pacientes com insuficiência cardíaca avançada

Abstract: Background: Anemia is linked with worsening of progress in patients with heart failure (HF). However, there are few studies of anemia in patients with advanced HF.

Cited by 9 publications

References 25 publications

Ações de autocuidado em portadores de insuficiência cardíaca

Ações de autocuidado em portadores de insuficiência cardíaca

Anemia in heart failure

Evaluation by N-terminal Prohormone of Brain Natriuretic Peptide Concentrations and Ross Scoring of the Efficacy of Digoxin in the Treatment of Heart Failure Secondary to Congenital Heart Disease With Left-to-Right Shunts

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