Anemia is Associated with Higher Mortality in Severe Heart Failure

ABSTRACT

BACKGROUNDS AND OBJECTIVES: Anemia could adversely affect the cardiovascular condition of the patients suffering with heart failure. This study aimed to elucidate the relationship between anemia and the prognosis of heart failure (HF). SUBJECTS AND METHODS: We enrolled the patients with a diagnosis of CHF who visited to our hospital from January 2000 and January 2001 and they had a left ventricular ejection fraction (EF) less than 40% and a left ventricular end diastolic dimension (LVEDd) larger than 5.7 cm. The hemoglobin (Hb) level was accessed at the time of the initial evaluation. The patients were divided into quartiles of Hb: Hb 14.8 g/dL. RESULTS: A total of 110 patients were enrolled; there were 71 men and 39 women. Anemia was found in 39 (35.5%) patients, and this was significantly more common in the women than in men (p=0.038). The lowest Hb group was more likely to be older and female, and they had severe symptoms (NYHA functional class III or IV), a lower diastolic BP and a wider QRS width. The total mortality was 24.5%. Mortality was higher with lower Hb quartile (46.2%, 28.6%, 17.9% and 7.1% for each quartile, respectively, p=0.002). On the multivariate analysis after adjusting for age, gender, NYHA functional class and the known HF prognostic factors, the lowest Hb level proved to be an independent predictor of mortality (p=0.019). CONCLUSION: In patients with congestive heart failure, anemia is relatively common and the mortality was higher for the lower Hb group. Anemia is an independent negative prognostic factor in patients with congestive heart failure.