Relationship between prevalence of anemia and cardiac function in hospitalized patients with chronic heart failure and influence of hemoglobin level on their mortalities / 第二军医大学学报

ABSTRACT

Objective: To investigate the relationship between the prevalence of anemia and New York Heart Association (NYHA) class in patients with chronic heart failure (CHF), and to assess the influence of hemoglobin (Hb) on patients' mortality. Methods: Totally 1 415 patients with CHF were retrospectively analyzed and the patients with secondary anemia or other serious conditions were excluded. Multivariable logistic analysis was used to assess the effect of Hb level on hospital mortality. Results: Among 1 415 patients, 413 (29.2%) were found to have anemia (Hb<120 g/L). The prevalence of anemia was positively correlated with the NYHA-class of patients (NYHA-class I 17.9% [5/28], class II 24.7% [125/507], class III 26.3% [151/574], and class IV 43.1% [132/306]. Patients with severe heart failure (NYHA-class III and IV [32.2%]) had a significantly higher prevalence of anemia than patients with slight heart failure (class I and II [24.3%], P<0.01). Patients with a Hb level of (140-159) g/L had the lowest hospital mortality, and those with Hb levels <80 g/L, (80-99) g/L, (100-119) g/L, (120-139) g/L, and ≥160 g/L had higher hospital mortalities. The relationship between mortality and Hb level was in a U-shaped manner. For patients with Hb level <160 g/L, multivariable logistic analysis showed that Hb remained as an independent predictor of the hospital mortality when the influences of the age, gender, basic cause of the disease, diabetes, cardiac function classification, serum creatinine, etc. were adjusted. Conclusion: Anemia is a common condition in hospitalized CHF patients and the degree of anemia is closely correlated with the severity of CHF. Hb level significantly influences the patients' hospital mortality. Hb level (<160 g/L) is an independent predictor of hospital mortality in the patients with CHF.