Abstract
Objective: Approximately 30% of patients with Chronic Heart Failure (CHF) develop anemia. Previous studies showed the beneficial effect of treating the underlying anemia in CHF patients but controversy on the subject remains. We studied the prevalence and treatment of underlying anemia in patients with CHF. Methods and Results: Patients were categorized into three groups: normal hemoglobin levels, anemia of chronic disease; and iron deficiency anemia (IDA). All patients were treated for heart failure. Patients with IDA were treated with iron sulfate. We compared the ejection fractions (EF) and functional capacities both before and after treatment. The prevalence of IDA in our patients was 10.7% and 25.7% of patients had anemia of chronic disease. The mortality rate in the anemic group was 4.9 times higher than the mortality rate in the normal hemoglobin group. Following treatment, there was a significant increase in hemoglobin levels that was more prominent in the IDA group. EF increased in all groups following treatment, but the increase was greatest in the IDA group. Conclusions: Our results demonstrate the improved quality of life that results from treating IDA as part of CHF patient management. Early diagnosis and treatment of anemia can improve EF in patients with CHF.
Highlights
Heart failure affects approximately 2% of the general population
In the IDA group, patients with an MCV
We compared creatinin level among three different group of Chronic Heart Failure (CHF) patients (Table 6) and our results showed lower creatinin values for patients with normal hemoglobin level while CHF patients with anemia of chronic disease showed the worst kidney function. (P value
Summary
Heart failure affects approximately 2% of the general population. Hospitalized patients with underlying heart failure have 25%-35% chance of mortality or morbidity within one year. In patients with underlying coronary artery disease, anemia may be misdiagnosed as fatigue, decreased exertional capacity, dyspnea, heart palpitations or exacerbation of angina [3]. IDA is more prevalent in young women (9%-11%), because its prevalence decreases to 5%-7% after menopause [4]. A previous study showed that 25% of all patients with severe heart failure develop anemia with a hemoglobin less than 12 mg/dl [1] various etiologies, including sodium or water retention, have been proposed as an underlying cause of anemia in patients with cardiac dysfunction; these etiologies are reported to cause hemodilution, decreased iron absorption, impaired iron metabolism, and increased inflammatory factors (e.g., IL-1, IL-6 and TNF) that cause a decrease in erythropoietin production [1]
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