title: Causes and correlates of anemia in 200 patients with acute cardiogenic pulmonary edema.
abstract: BACKGROUND
  Acute heart failure has a poor prognosis and the presence of anemia may increase the risk of adverse outcomes. However, the clinical and laboratory characteristics of anemia in acute heart failure are poorly known. We aimed to assess the causes and the clinical and laboratory correlates of anemia in patients with acute cardiogenic pulmonary edema (ACPE).
  
  
  METHODS
  This observational study, performed in an Emergency Unit, enrolled 200 patients treated with medical therapy and continuous positive airway pressure.
  
  
  RESULTS
  Anemia was found in 36% of patients (38.5% of females and 32.5% of males) and was severe (hemoglobin <9 g/dL) in 6.9% of cases. The most frequent causes of anemia were chronic renal failure (27.8%), chronic inflammatory states (27.8%) and the clustering of multiple factors (18.1%). A wider spectrum of etiological factors was found in females than in males. Microcytic anemia was observed only in females (20% of those anemic), mainly due to iron deficiency/chronic blood loss. Glomerular filtration rate, serum iron, serum albumin, total cholesterol and diastolic blood pressure were independently associated with hemoglobin levels.
  
  
  CONCLUSIONS
  The etiology of anemia in ACPE is heterogeneous, with several causal factors besides impaired renal function. The pattern of anemia is different between genders, suggesting that sex-specific diagnostic and therapeutic targets should be implemented.
authors: Emergency Medicine Unit, Department of Medicine and Medical Specialties, IRCCS Ca' Granda Maggiore Policlinico Hospital Foundation, Milan, Italy. angelo.rovellini@policlinico.mi.it
authors: Angelo
authors: A
authors: Rovellini
authors: Giovanna
authors: G
authors: Graziadei
authors: Christian
authors: C
authors: Folli
authors: Anna Maria
authors: AM
authors: Brambilla
authors: Roberto
authors: R
authors: Cosentini
authors: Ciro
authors: C
authors: Canetta
authors: Valter
authors: V
authors: Monzani
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D002908:Chronic Disease; D004632:Emergency Medical Services; D004909:Erythrocyte Indices; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000453:epidemiology; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D011654:Pulmonary Edema / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D017678:Sex Distribution
chemical_list: D006454:Hemoglobins