Anaemia in heart failure: a prospective evaluation of clinical outcome in a community population.
BACKGROUND
Although anaemia is associated with an adverse prognosis in congestive heart failure (HF), the cause of the anaemia and its relationship to non-cardiac and cardiac complications needs to be better defined, particularly in a general community population.


METHODS
Clinical data were collected prospectively from 959 patients hospitalised with HF.


RESULTS
Thirty-eight percent (n=369) had anaemia (Hb<120 g/L), which was normochromic normocytic in 87.8%. Of those who had haematinic studies, 15.5% had a confirmed haematinic deficiency. Anaemic patients were of similar age to non-anaemic (79 vs 77 years) but were more likely to have elevated creatinine (48 vs 29%, p<0.001), hyponatremia (20 vs 15%, p=0.05), and LVEF>40% (49 vs 39%, p=0.004), and less likely to receive ACE inhibitors (72 vs 78%, p=0.04). At 12 months, anaemic patients had higher HF readmission rates (22.4 vs 15.7%, p=0.01), more multiple non-HF readmissions (12.4 vs 6.3%, p=0.001) and a higher mortality (16.4% vs 10.5%, p=0.01).


CONCLUSIONS
Anaemia is common (38%) in community patients hospitalised with HF, and is associated with increased HF and non-HF readmissions, and increased mortality. A haematinic deficiency was identified in 15.5% of patients. Anaemia is a common, multifactorial, but potentially treatable cause of adverse outcome in HF.
Stewart
Tanya
T
Coffs Harbour Hospital, St., Darlinighurst, NSW 2011, Australia. the_tanya@hotmail.com
Freeman
Jane
J
Stewart
Jessica
J
Sullivan
Anne
A
Ward
Christopher
C
Tofler
Geoffrey H
GH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications* / Q000453:epidemiology* / Q000209:etiology; D001315:Australia / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000401:mortality*; D006764:Hospitals, Community; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D055815:Young Adult