Prevalence and Clinical Implications of Anemia in Congestive Heart Failure Patients Followed at a Specialized

Abstract

The objective of this study was to assess the prevalence of anemia and to investigate its association with comorbidities and its impact on clinical outcomes in patients with heart failure. The association of predefined anemia, as well as the correlation of serum hemoglobin level as a continuous variable, with outcomes of emergency department visits, hospitalization, and mortality was investigated. There were fewer anemic patients in New York Heart Association classes I and II than in classes III and IV. Anemia was associated with higher rates of emergency department visits, hospital admissions, and all-cause mortality. Multivariable analysis showed that anemia is independently associated with mortality. When hemoglobin level was considered as a continuous variable, the authors noted that the mortality risk correlated with hemoglobin level disappears when hemoglobin level exceeds 140 g/L. The authors conclude that anemia has strong impacts on functional class and other clinical outcomes in patients with heart failure.

Anemia and Early Mortality in Patients with Decompensation of Chronic Heart Failure

“…In point of fact the present findings, in a relatively large sample of patients with decompensation of CHF, seem to conflict with many previous studies which suggest that anemia strongly and independently predicts mortality in mostly stable CHF patients and preserves or reduces the left ventricular ejection fraction [2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21]. Although this discrepancy could be attributed to the nature of the illness (e.g.…”

“…Secondary analyses of randomized trials, by the selection of younger and healthier CHF patients, are not representative of the everyday clinical practice CHF patients in whom noncardiac comorbidities are highly prevalent [15,16,17,18,19,20,21]. On the other hand in some previously published prospective observational studies, in which the included patients were more representative of the everyday clinical practice, only partial adjustment for noncardiac comorbidities was accomplished [12,13,14]. …”

“…Anemia is one of the most frequently observed comorbidities in patients with chronic heart failure (CHF) [1], and the question of whether anemia is a marker or a mediator of increased mortality rates in these patients has not been definitely answered by previous studies [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26]. Moreover, despite advances in the treatment of patients with CHF, the majority experience decompensation which mandates hospitalization and intensive medical management [27,28].…”

Malnutrition and associated factors among heart failure patients on follow up at Jimma university specialized hospital, Ethiopia

“…In our study, the odds of malnutrition were higher in those who had lower serum hemoglobin level, this is in line with current knowledge [ 3 , 24 , 25 ]. It is well known that anemia has a strong impact on NYHA functional class in heart failure [ 40 ]. A Canadian study identified anemia by itself had a strong impact on clinical outcome of heart failure patients with higher number of anemic patients fitting to a higher functional class of heart failure [ 39 ].…”

Anemia and Mortality in Heart Failure Patients

“…Prevalence of anemia depends both on the severity of CHF and diagnostic criteria used to define it, but may be as high as 50% in selected patient cohorts (3,6). Of note, anemia is not only prevalent in the CHF population, but several studies in different patient populations found an association with anemia, impaired cardiac function, more health care utilization, and morbidity (1,(7)(8)(9)(10)(11). In addition, numerous studies have assessed associations between anemia and mortality in CHF.…”