title: [Hronic heart failure and concomitant diseases in elderly patients: anemia and cardio-renal anemic syndrome].
abstract: to assess impact of anemia on chronic heart failure (CHF) course in elderly patients in primary care setting. Methods. We examined 164 outpatients (n=164) aged 60-85 years with clinically stable CHF due to ischemic heart disease and arterial hypertension. All patients underwent clinical, laboratorial evaluation, ECG, EchoCG measurements, 6 min walk test. Patients were categorized according to the presence of anemia, as defined by the WHO criteria (hemoglobin levels <13 g/dl in men and <12 g/dl in women). Median duration of follow up was 1.85 (1.0-4.75) years. Results. Anemia was found in 32.9%, cardio-renal anemic syndrome (CRAS) in 23.2% of patients. In all patients anemia was mild (Hb>9 g/dl). It was associated with diabetes mellitus (odds ratio [R] 2.2, 95% CI 1.03-4.69, =0.041), high creatinine level (R 2.76, 95% CI 1.25-6.12, =0.012) and chronic kidney disease (R 5.66, 95% CI 2.51-12.77, <0.001). During follow-up mortality rate was similar among anemic and non-anemic patients (27.8 vs 30%, =0.768). Patients with CRAS had worse survival compared with patients of the same age without anemia and preserved kidney function (=0.004). Age >75 years (R 3.58, 95% CI 1.59-7.99, =0.002), diabetes (R 2.68, 95% CI 1.19-6.04, =0.018), history of myocardial infarction (R 2.7, 95% CI 1.24-6.04, =0.013), systolic blood pressure <110 mm Hg (OR 2.49, 95% CI 1.09-5.71, =0.030), complete left bundle branch block (LBBB) (OR 2.79, 95% CI 1.26-8.22, =0.012), creatinine >130 mmol/l (OR 3.53, 95% CI 1.51-8.22, =0.004) were predictors of mortality of elderly patients with CRAS. Conclusions. CHF patients with and without anemia had similar survival but survival of those with CRAS was worse compared with patients without anemia and preserved kidney function. Age >75 years, diabetes mellitus, history of myocardial infarction, low systolic blood pressure, complete LBBB, high creatinine level were predictors of mortality in patients with CRAS.
authors.forename: V N
authors.initials: VN
authors.lastname: Larina
authors.forename: B Ia
authors.initials: BIa
authors.lastname: Bart
authors.forename: T N
authors.initials: TN
authors.lastname: Raspopova
authors.forename: V G
authors.initials: VG
authors.lastname: Larin
mesh_terms: D000368:Aged; D000740:Anemia / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D059347:Cardio-Renal Syndrome / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D002908:Chronic Disease; D015897:Comorbidity; D003404:Creatinine / Q000097:blood*; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology; D006334:Heart Function Tests / Q000379:methods; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D009026:Mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012426:Russia / Q000453:epidemiology; D012720:Severity of Illness Index
chemical_list: D006454:Hemoglobins; D003404:Creatinine