Prognostic implications of Anemia in patients with Acute Heart Failure
in emergency departments. ANEM-AHF Study.
INTRODUCTION: The anemia leads to a worse prognosis in patients with
heart failure(HF). There are few data on the impact of anemia on
mortality in patients with acute heart failiure(AHF), and the studies
available are mainly retrospective and include hospitalized patients.
OBJECTIVE. Evaluate the role of anemia in 30-days and one-year mortality
in patients with AHF attended in hospital emergency departments(HEDs).
METHODS. Multicenter, observational study of prospective cohorts of
patients with AHF. Study variables: anemia(hemoglobin<12g/dL
in women and <13g/dL in men), 30-days-mortality and at one
year, risk factors, comorbidity, functional impairment, basal functional
grade for dyspnea, chronic and acute treatment, clinical and analytical
data of the episode and patient destination. Statistical analysis:
bivariate analysis and survival analyses using Cox regression. RESULTS.
A total of 13,454 patients were included, 7662(56.9%) of whom had
anemia. Those with anemia were older, had more comorbidity, a worse
functional status and New York Heart Association class, greater renal
function impairment and more hyponatremia. The mortality was higher in
patients with anemia at 30-days and one-year: 7.5% vs.
10.7%(p<0.001) and 21.2% vs. 31.4%(p<0.001),
respectively. The crude and adjusted hazard ratios of anemia for
30-days-mortality were: 1.46(confidence interval[CI]95%
1.30-1.64);p<0.001 and 1.20(CI95% 1.05-1.38);p=0.009,
respectively, and 1.57(CI95% 1.47-1.68) and 1.30(CI95% 1.20-1.40) for
one-year-mortality. The weight of anemia on mortality was different in
each follow-up period. CONCLUSIONS. Anemia is an independent predictor
of 30-days-mortality and one year in patients with AHF attended in HEDs.
It is important to study the etiology of AHF since adequate treatment
would reduce mortality.