[Anemia in patients with advanced heart failure].
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.


OBJECTIVE
to evaluate the characteristics of anemia in HF at an advanced stage.


METHODS
the study included 99 patients, aged > 18 and LVEF < 45%, who were hospitalized for HF compensation (FC IV/NYHA). Patients with hemoglobin (Hb) levels < 12 g/dl were considered anemic. Data on anemic and nonanemic patients were compared. The Student's t-test, Chi-square test and Fisher test were used. The relative risk (HF 95%) was calculated by the Cox regression.


RESULTS
on average, the patients were monitored for 10.8 months (8.9), and 34.3% of patients with HF had anemia. On average, in comparison with nonanemic patients, anemic patients were older (64.1 ± 15.6 versus 54.8 ± 12.9 years old, p = 0.004), their creatinine level was higher (1.9 ± 1 versus 1.5 + 0.5 mg/dl, p = 0.018) and their BNP level was also higher (2,077.4 ± 1,979.4 versus 1,212.56 ± 1,080.6 pg/ml, p = 0.026). 38.24% of the anemic patients had iron deficiency anemia. After there was an improvement in the congestion, only 25% of patients with anemia were discharged with Hb > 12 g/dl. Anemia was an independent marker of poor prognosis in the multivariate analysis (mortality of 47% vs 24.6%, p = 0.016, relative risk of 2.54).


CONCLUSIONS
anemia affects approximately one third of patients with advanced HF, and iron deficiency is an important etiology. Anemic patients are older their renal function was more deteriorated. The improvement in the congestion was not enough to improve the anemia in most cases. In patients with advanced HF, anemia is an independent marker of poor prognosis.
Cardoso
Juliano
J
Hospital Cotoxó InCor, FMUSP, São Paulo, SP, Brasil. julianonc@cardiol.br
Brito
Michel Ibrahim
MI
Ochiai
Marcelo Eidi
ME
Novaes
Milena
M
Berganin
Fabrício
F
Thicon
Tatiana
T
Ferreira
Elaine C
EC
Regina
Kelly
K
Reis
Cristina Martins Dos
CM
Barretto
Antonio Carlos Pereira
AC
D000740:Anemia / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D004812:Epidemiologic Methods; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012016:Reference Values
D015415:Biomarkers