Prevalence, prognostic importance and therapeutic implications of anemia in heart failure.
BACKGROUND
Despite advances in its management, heart failure, once established, remains highly prevalent and lethal. Anemia can exacerbate the hemodynamic burden in heart failure. The present study was undertaken to assess the presence of anemia and analyze how its control impacts the outcome in heart failure patients.


RESULTS
From a cohort of 238 heart failure patients, 55 (231%) patients were found to be anemic. Twenty-nine patients (Group A) were given recombinant human erythropoietin for 12 weeks along with iron, and followed up for a mean period of 24 +/- 6 months. The patients improved substantially in terms of functional capacity (6 min walk test improved from 232 +/- 35 m to 278 +/- 41 m, p < 0.001), hemoglobin level from 10.1 +/- 0.90 gm/dl to 12 +/- 0.7 gm/dl, (p < or = 0.001), and ejection fraction from 33 +/- 7.1% to 41 +/- 6.9% (p < or = 0.001). Twenty-six patients (Group B) who were age- and sex-matched with Group A and had similar degree of functional disability and left ventricular dysfunction as that of Group A were not given erythropoietin and iron. Thus, Group B patients served as controls. In comparison to Group B, Group A patients demonstrated not only higher hemoglobin level (12 +/- 0.7 gm/dl v. 9.8 +/- 0.9 gm/dl, p < or = 0.001), and ejection fraction (41 +/- 6.9% v. 26 +/- 7%, p < or = 0.05), but also better survival (16/29 v. 7/26, p < 0.05, odds ratio 1.27).


CONCLUSIONS
Anemia is a significant predictor of poor outcome in patients with heart failure. Administration of erythropoietin can correct anemia and help improve survival.
Mishra
Trinath K
TK
Department of Cardiology, MKCG Medical College and Hospital, Berhampur. drtkmishra@yahoo.com
Mishra
Sura K
SK
Mohanty
Nirmal K
NK
Rath
Pravin K
PK
D017677:Age Distribution; D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D016022:Case-Control Studies; D015897:Comorbidity; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D011336:Probability; D011379:Prognosis; D011994:Recombinant Proteins; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis; D016896:Treatment Outcome
D011994:Recombinant Proteins; D004921:Erythropoietin