[Prognostic impact of anemia in acute heart failure]

Studies performed on selected patients in other countries have shown that anemia is frequently associated with heart failure and results in a worse prognosis. We sought to determine the prognosis significance of hemoglobin/anemia in patients with acute heart failure which required management with hospital admission.

We analysed 412 patients diagnosed with acute heart failure as outlined in the criteria of the European Society of Cardiology (ESC). We measured hemoglobin within the first 24 hours and obtained demographic, clinical and biochemical variables. Anemia was defined in accordance with OMS criteria. The main variable was all-cause mortality. The association between all-cause mortality and hemoglobin/anemia was determined using the multiple regression Cox model.

During follow-up (median six months) we observed 101 all-cause mortality events. In the multivariate analysis, hemoglobin was an independent predictive variable adjusted by covariates (HR 1.15, IC 95% [1.04-1.25], p = 0.014). Anemia (hemoglobin < 13 g/dL) was also found to be an independent predictive variable adjusted by covariates (HR 2.06, IC al 95% [1.28-3.33], p = 0.003).

Hemoglobin and anemia (hemoglobin < 13 g/dL) are consistently associated with short-term, poorer survival in patients with acute heart failure.