The prevalence of anemia in chronic heart failure

Frequent non-cardiac comorbidities in patients with chronic heart failure

“…Chronic obstructive pulmonary disease Braunstein et al [6] In the Medicare study 26% of the patients had COPD Gustafsson et al [9] In the Danish Diamond study 22% had COPD Ni et al [53] In this study only 10% had COPD McCullough et al [54] In this Emergency department study 21% of the patients had COPD Anemia Tanner et al [59] The prevalence of anemia was 15% Ezekowitz et al [60] The prevalence of anemia was 17% Silverberg et al [61] The prevalence of anemia was 50% and in patients with severe HF 80% Komajda [62] In this review the prevalence of anemia and its clinical characteristics are discussed Efficacy of heart failure treatment similar in diabetic and nondiabetic patients Rydén et al [28] Similar effect in the ATLAS study as in the SOLVD study (Shindler et al [25]) CIBIS II trial [49] Similar results in the CIBIS II-study evaluating the effect of a beta-blocker The Task force of the ESC [50] Loop-diuretics are recommended instead of thiazide diuretics in patients with diabetes, because of the hypothesis that thiazide diuretics may impair the metabolic state in diabetic patients Herings RBM et al [51] Since it has been reported hypoglycemia in connection with treatment with ACE-inhibitors careful monitoring is recommended Malmberg et al [52] Aggressive insulin treatment has not been performed in patients with heart failure but in patients with acute myocardial infarction and with a favourable outcome Chronic obstructive pulmonary disease Gosker et al [56] If use of beta-blockers beta-1 selective beta-blockers as bisoprolol is recommended Salpeter et al [57] Similar results shown in this meta-analysis, beta-1-selective beta-blockers are recommended Anemia Anand et al [72] Blood transfusions have shown beneficial effects in terms of clinical improvement Low-Friedrich et al [74] Administration of erythropoietin has beneficial effects in terms of unloading the heart Silverberg et al [66] Administration of erythropoietin together with intravenous iron improve cardiac and renal function, NYHA functional class and morbidity (reduce heavily the number of hospitalisations due to heart failure)…”

“…Papers reporting the prevalence of anemia in patients with HF are shown in Table 1 [59][60][61][62]. The prevalence of anemia in different studies varies since an exact definition for anemia (cut-off value of hemoglobin) is still lacking.…”

The Role of Anemia in the Progression of Congestive Heart Failure: Is There a Place for Erythropoietin and Intravenous Iron?

“…Of 21 studies that looked at the relationship between severity of CHF and anemia, 17 (81%) showed that the presence of anemia was associated with a more severe degree of CHF as judged by NYHA functional class. Of the 33 studies that examined the relationship between mortality and anemia in CHF, 31 (93.9%) showed a positive relationship, one 5 did not and one 63 was borderline. In many of these studies, these relationships between anemia and CHF were still statistically significant by multivariate analysis where renal function and age were also taken into consideration -that is, anemia was an independent risk factor for cardiac mortality.…”

Approaches to the treatment of anaemia in patients with chronic heart failure

“…An association between anaemia, poor functional status and, compared to non-anaemic patients, worse clinical status and a higher risk of hospitalisation and death has been consistently reported in CHF, although cause an effect has not been proven [3,[4][5][6][7][8][9][10][11][12][13][14][15].…”

“…Surprisingly, although we know much about the prevalence and prognostic importance of anaemia in these patients, we know very little about its causation. We think the aetiology of anaemia in CHF is multifactorial, with impaired iron metabolism, bone marrow suppression by pro-inflammatory cytokines, inadequate erythropoietin production and blunted response to erythropoietin in the bone marrow among the suspected culprits [6,10,[16][17][18][19][20][21][22]. Other potential candidates include renal dysfunction, salt and water retention causing haemodilution and the use of drugs such as antiplatelet and anticoagulant agents which increase the risk of blood loss from the gastrointestinal tract [6,10,[16][17][18][19][20][21][22].…”