Anaemia in Heart Failure: A Prospective Evaluation of Clinical Outcome in a Community Population

IntroductionAlthough anaemia is associated with an adverse prognosis in congestive heart failure (HF), the cause of the anaemia and its relationship to non-cardiac and cardiac complications needs to be better defined, particularly in a general community population.MethodsClinical data were collected prospectively from 959 patients hospitalised with HF.ResultsThirty-eight percent (n = 369) had anaemia (Hb < 120 g/L), which was normochromic normocytic in 87.8%. Of those who had haematinic studies, 15.5% had a confirmed haematinic deficiency. Anaemic patients were of similar age to non-anaemic (79 vs 77 years) but were more likely to have elevated creatinine (48 vs 29%, p < 0.001), hyponatremia (20 vs 15%, p = 0.05), and LVEF > 40% (49 vs 39%, p = 0.004), and less likely to receive ACE inhibitors (72 vs 78%, p = 0.04). At 12 months, anaemic patients had higher HF readmission rates (22.4 vs 15.7%, p = 0.01), more multiple non-HF readmissions (12.4 vs 6.3%, p = 0.001) and a higher mortality (16.4% vs 10.5%, p = 0.01).ConclusionAnaemia is common (38%) in community patients hospitalised with HF, and is associated with increased HF and non-HF readmissions, and increased mortality. A haematinic deficiency was identified in 15.5% of patients. Anaemia is a common, multifactorial, but potentially treatable cause of adverse outcome in HF.