title: Heart failure and iron deficiency anemia in Italy: results from CARMES-1 registry.
abstract: OBJECTIVE
  To assess the prevalence of anemia and iron deficiency anemia in heart failure (HF) patients, to evaluate the effectiveness of current iron deficiency treatment strategies after discharge, and to analyze hospital readmissions and mortality rates in patients with and without anemia.
  
  
  METHODS
  A patient registry-based, multicenter, retrospective, observational, cohort study of 418 hospitalized HF patients in Italy, monitored from 1 March 2010 to 30 March 2011.
  
  
  RESULTS
  Among patients with HF, 35.9% had anemia at admission; only 51.3% were treated with current iron deficiency treatment strategies during hospitalization and then only 29% of patients who were anemic at discharge were treated with iron at home. After a 4-week follow-up, only 11% of these patients reached the hemoglobin target value (study primary end point). However, current iron deficiency treatment strategies were not significantly associated with reduced risk of rehospitalization, but with a significantly reduced mortality rate after a 6-month follow-up (study secondary end points: 11.7 vs 51.7%; p < 0.0001).
  
  
  CONCLUSIONS
  In HF patients, there is poor attention paid to anemia, its causes and treatment. Current iron deficiency treatment strategies are mismanaged and CARMES-1 demonstrated that they appear to be insufficient at improving patient outcome in terms of rehospitalization rate reduction, generating high costs, which could be avoided through an optimized treatment strategy. Therefore, more efficacious, efficient and cost-effective treatment strategies are required in Italy for HF patients with iron deficiency anemia to meet this unmet medical need.
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrological, Anesthesiology and Geriatric Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
authors.forename: Carmen
authors.initials: C
authors.lastname: Caira
authors.forename: Gerardo
authors.initials: G
authors.lastname: Ansalone
authors.forename: Massimo
authors.initials: M
authors.lastname: Mancone
authors.forename: Emanuele
authors.initials: E
authors.lastname: Canali
authors.forename: Michela
authors.initials: M
authors.lastname: Pagliaro
authors.forename: Lara
authors.initials: L
authors.lastname: Fratarcangeli
authors.forename: Carlos Alberto Centurion
authors.initials: CA
authors.lastname: Aznaran
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Gatto
authors.forename: Riccardo
authors.initials: R
authors.lastname: Di Pietro
authors.forename: Francesco
authors.initials: F
authors.lastname: Fedele
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D017052:Hospital Mortality; D006801:Humans; D007297:Inpatients; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies