Circulation. 2003;107:223-225
Published online before print January 6, 2003, doi: 10.1161/01.CIR.0000052622.51963.FC
Published online before print January 6, 2003, doi: 10.1161/01.CIR.0000052622.51963.FC
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(Circulation. 2003;107:223.)
© 2003 American Heart Association, Inc.
Brief Rapid Communications |
Anemia Is Common in Heart Failure and Is Associated With Poor Outcomes
Insights From a Cohort of 12 065 Patients With New-Onset Heart Failure
From the Division of Cardiology (J.A.E., P.W.A.) and the Division of General Internal Medicine (F.A.M.), University of Alberta, Edmonton, Alberta, Canada.
Correspondence to Paul W. Armstrong, MD, 2-51 Medical Sciences Building, University of Alberta, Edmonton, Alberta, Canada T6G 2H7. E-mail paul.armstrong{at}ualberta.ca
Background— Although previous work has suggested that anemia is associated with an increased mortality in selected patients with congestive heart failure (CHF), little is known about the prevalence and predictors of anemia, or whether anemia is an independent prognostic factor in unselected, community-based patients with CHF.
Methods and Results— We analyzed a population-based cohort of patients with new-onset CHF from a database of patients discharged from 138 acute-care hospitals in Alberta, Canada, between April 1993 and March 2001. Logistic regression, Kaplan-Meier survival analyses, and Cox proportional hazards model were used. Among the 12 065 patients with CHF (median age 78 years), 17% had anemia, 58% of whom had anemia of chronic disease. After adjustment for clinical and demographic variables, patients with anemia were more likely to be older (odds ratio [OR] 1.01 per year) and female (OR 1.2 [95% confidence interval 1.1 to 1.3]) and to have a history of chronic renal insufficiency (OR=3.2 [95% confidence interval 2.8 to 3.6]), or hypertension (OR 1.3 [95% confidence interval 1.2 to 1.5]). Hazard ratios for mortality, adjusting for covariates, were 1.34 (1.24 to 1.46) in anemic patients, and 1.36 (1.23 to 1.50) in those patients with anemia of chronic disease.
Conclusions— In this large cohort of community-dwelling patients with CHF, anemia is common and an independent prognostic factor for mortality. Further research into the mechanisms of anemia in CHF and randomized controlled trials to test whether correction of anemia improves prognosis in CHF are needed.
Key Words: anemia • heart failure • epidemiology
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K. Schroecksnadel, B. Wirleitner, D. Fuchs, W. Steinborn, P. Ponikowski, S. Anker, P. van der Meer, W. H. van Gilst, D. J. van Veldhuisen, J. Ezekowitz, et al. Anemia and Congestive Heart Failure * Response Circulation, August 12, 2003; 108 (6): e41 - e42. [Full Text] [PDF]
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 OTHER ARTICLES NOTED (24 Jan 03 to 18 Apr 03) Evid. Based Nurs., July 1, 2003; 6(3): e1 - 12. [Full Text] [PDF]
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 Minerva BMJ, February 8, 2003; 326(7384): 344 - 344. [Full Text] [PDF]
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