[Anaemia predicts mortality in heart failure].
BACKGROUND
Anaemia frequently coexists with heart failure. Few studies have examined the impact of anaemia on mortality in this population.


OBJECTIVE
To assess the prevalence of anaemia in patients with heart failure in an Internal Medicine Unit and its potential effects on mortality.


METHODS
We evaluated the electronic medical records of 272 patients with heart failure that fulfilled the criteria admitted to the Internal Medicine Unit of Fundación Hospital Alcorcón (Madrid, Spain)between July and December 2003. Uni and multivariate logistic regression analysis for predictors of mortality.


RESULTS
Most patients were women (71%), mean age was 82.1+/-9 years, 106 (39.9%) had anaemia (serum haemoglobin levels<12 g/dL), 69 (25%) had renal failure (serum creatinine levels>1.5 mg/dL and 154 patients (57%) had atrial fibrillation. There were 41 deaths (15%). The frequency of anaemia was higher and the haemoglobin levels were lower in the patients who died (65% vs 36%, and 11.2+/-2.4 g/dL vs 12.6+/-2.1g/dL, p<0.001 for both). Increased serum creatinine was also associated with mortality (1.8+/-0.8 vs 1.3+/-0.8 mg/dL p<0.001). Age, gender, atrial fibrillation or the aetiology of heart failure were not associated with mortality in univariate analysis. In contrast, by multivariate logistic regression analysis, haemoglobin (odds ratio [OR] 0, 78 per g/dL, 95%confidence interval [CI] 0.66- 0.923 p<0.01), New York Heart Association functional classification (OR 2.2, 95% Cl 1.2-3.9 p<0.01), and serum creatinine (OR 1.5 per mg/dL, 95% CI 0.98-2.31 p=0.06) were independent predictors of mortality.


CONCLUSIONS
Anaemia is a frequent problem among patients with heart failure and it is a significant independent risk factor for death.
García de Casasola
G
G
Unidad de Medicina Interna, Fundación Hospital Alcorcón, Madrid, Spain. ggcasasola@fhalcorcon.es
Cárdenas Franco
C
C
Vegas Serrano
A
A
Hornero Izquierdo
M A
MA
Guijarro Herraiz
C
C
Zapatero Gaviria
A
A
D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications*; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors