Original Article Anemia in Patients with Advanced Heart Failure

Background: Anemia is linked with worsening of progress in patients with heart failure (HF). However, there are few studies of anemia in patients with advanced HF. Objective: To evaluate the characteristics of anemia in HF at an advanced stage. Methods: The study included 99 patients, aged ≥ 18 and LVEF ≤ 45%, who were hospitalized for HF compensation (FC IV/NYHA). Patients with hemoglobin (Hb) levels < 12 g/dl were considered anemic. Data on anemic and nonanemic patients were compared. The Student’s t-test, Chi-square test and Fisher test were used. The relative risk (HF 95%) was calculated by the Cox regression. Results: On average, the patients were monitored for 10.8 months (8.9), and 34.3 % of patients with HF had anemia. On average, in comparison with nonanemic patients, anemic patients were older (64.1 ± 15.6 versus 54.8 ± 12.9 years old, p = 0.004), their creatinine level was higher (1.9 ± 1 versus 1.5 + 0.5 mg/dl, p = 0.018) and their BNP level was also higher (2,077.4 ± 1,979.4 versus 1,212.56 ± 1,080.6 pg/ml, p = 0.026). 38.24 % of the anemic patients had iron deficiency anemia. After there was an improvement in the congestion, only 25 % of patients with anemia were discharged with Hb ≥ 12 g/dl. Anemia was an independent marker of poor prognosis in the multivariate analysis (mortality of 47% vs 24.6%, p = 0.016, relative risk of 2.54). Conclusion: Anemia affects approximately one third of patients with advanced HF, and iron deficiency is an important etiology. Anemic patients are older their renal function was more deteriorated. The improvement in the congestion was not enough to improve the anemia in most cases. In patients with advanced HF, anemia is an independent marker o