Abstract 9532: Anaemic Patients With Chronic Heart Failure are Common in Clinical Practice, Insufficiently Treated and With an Impaired Prognosis Independent of Confounding Factors
Introduction: There is an increasing interest in the role of anaemia in patients with heart failure (HF). We analyzed data of the EVITA-HF registry with respect to prevalence, therapy and prognosis of patients with chronic HF and hemoglobin < 12 g/dl in the actual clinical practice.
Methods: The EVITA-HF registry is a multicenter registry of consecutive patients with chronic HF and left ventricular ejection fraction < 40%. Data are collected in 17 centers in Germany, Austria and Switzerland.
Results: 3082 HF-patients were included in the EVITA-HF registry in the time period 01/2009 to 03/2012. In 734 patients (23.8%) hemoglobin levels were < 12 g/dl. Anaemic patients were older (71 + 12 years vs. 65 + 13 years, p < 0.01) and more often female (33.2% vs. 20.6%, p < 0.01) than patients without anaemia and had a higher rate of comorbidities as renal failure and malignant comorbidities. Patients with anaemia received less often adequate medical HF-therapy (especially ACE inhibitors, aldosterone antagonists), had a lower rate of oral anticoagulatives in spite of a high rate of atrial fibrillation and had less often ICD/CRT implanted (32.1% vs. 40.3%, p <0.01) compared to patients without anaemia. Patients with anaemia had a worse clinical outcome compared to their non-anaemic counterparts with a significantly increased hospital (3.8% vs. 1.4%, p < 0.01) and 1-year mortality (23.3% vs. 10.6%, p <0.01). In a multivariate analysis adjusting for 14 prognostic factors hemoglobin < 12 g/dl was independently associated with a significantly elevated 1-year mortality (HR 1.45, 95% CI 1.04-2.02, p 0.031).
Conclusions: Nearly ¼ of the HF-patients of the EVITA-HF registry had hemoglobin levels < 12 g/dl. These patients received less often adequate guideline-recommended HF-therapy compared to non-anaemic patients. HF-patients with hemoglobin < 12 g/dl had a more than doubled 1-year mortality, nearly every fourth of these patients died within 1 year. Anaemia in HF-patients was not only a marker of a high-risk patient group, but also an independent prognostic risk factor in a multivariate analysis.
- © 2012 by American Heart Association, Inc.