Impact of anemia on long-term clinical outcomes in heart failure patients

Introduction: Background: Heart failure (HF) is a clinical syndrome which, epidemiologically, is in a continuous growth despite advances in its treatment. Th e high mortality associated with heart failure points to an increased attention towards additional risk factors having impact to HF. Aim: Estimate the impact of anemia and development of a prognostic model to estimate the survival of patients with HF based on information straightforwardly available in any hospital. Methods: Material and method: A database of 101 patients diagnosed with HF and hospitalized in the “Bagdasar-Arseni” Clinical Emergency Hospital, in the period from January 2005 to April 2008, was analyzed using the Cox proportional hazards regression multivariate model. Th e estimation of the model parameters was obtained with the maximum partial likelihood method. The patients were subsequently monitored until 30June 2010. Results: We note that 49.8% of patients with HF survive more than 44 months. Anemia was observed in 35 patients (34.65%). Anemia was mild in 31 patients and moderate in 4 patients. Subjects with anemia were older, and more likely to be female (46% vs 23.53% in male, p = 0,04). 50% of patients with heart failure and mild anemia survive more than 36 months, and half of the patients in group 3 – without anemia survive more than 52 months. Relative risk compared with covariates hemoglobin is 0.7716, p = 0.0011. Mean risk intensity decreases by 22.84% for an increase of one (1 g/dL) hemoglobin. From the 52 investigated predictors, 15 predictive factors are included in a prediction model. Conclusions: Anemia was observed among 34.65% acute HF patients. Th e clinical impact of anemia on HF patients might be stronger in patients with older age, male, chronic kidney disease, low ejection fraction, and severe heart failure symptom. Mild anemia is associated with long term mortality. A prognostic model is produced on the foundation of easily in any hospital available information that off ers an estimation of the survival probability beyond a specifi ed time moment for a patient with HF.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
ESC search engine
CODE: 379
CME Credits: 10 (Romanian College of Physicians)