Click on the icon on the upper right hand side for the article written by Howard S. Oster, MD, PhD, Michal Benderly, PhD, Michael Hoffman, MD, Eytan Cohen, MD, Avraham Shotan, MD and Moshe Mittelman, MD.
IMAJ 2013: 15: July: 436-440
Abstract
Background: Anemia is common in heart failure (HF), but there is controversy regarding its contribution to morbidity and mortality.
Objective: To examine the association of mild and severe anemia with acute HF severity and mortality.
Methods: Data were prospectively collected for patients admitted to all departments of medicine and cardiology throughout the country during 2 months in 2003 as part of the Heart Failure Survey in Israel. Anemia was defined as hemoglobin (Hb) < 12 g/dl for women and < 13 g/dl for men; Hb < 10 g/dl was considered as severe anemia. Mortality data were obtained from the Israel population registry. Median follow-up was 33.6 months.
Results: Of 4102 HF patients, 2332 had acute HF and available hemoglobin data. Anemia was common (55%) and correlated with worse baseline HF. Most signs and symptoms of acute HF were similar among all groups, but mortality was greater in anemic patients. Mortality rates at 6 months were 14.9%, 23.7% and 26.3% for patients with no anemia, mild anemia, and severe anemia, respectively (P < 0.0001), and 22.2%, 33.6% and 39.9% at one year, respectively (P < 0.0001). Compared to patients without anemia, multivariable adjusted hazard ratio was 1.35 for mild anemia and 1.50 for severe anemia (confidence interval 1.20–1.52 and 1.27–1.77 respectively).
Conclusions: Anemia is common in patients with acute HF and is associated with increased mortality correlated with the degree of anemia.
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