The prevalence of anemia in chronic heart failure and its impact on the clinical outcomes

Abstract

This review article summarizes the current medical literature reporting on the prevalence and prognostic significance of anemia in patients with heart failure. Almost all currently available data indicate that anemia is common in heart failure populations, with the majority of studies indicating prevalence >20%. Anemia appears to be more highly prevalent in patients with advanced age, with more severe limitations in functional capacity, and with greater severity of co-morbid chronic kidney disease. In most reported studies anemia is an independent predictor of increased mortality risk and increased risk of hospitalization for heart failure. These data provide the rationale for interventional treatment trials to determine if anemia is in the causal pathway for disease progression and increased mortality risk in HF patients.

Relationship of resting hemoglobin concentration to peak oxygen uptake in heart failure patients

“…This study shows, in accordance with several previous reports, that anemia is frequent in chronic HF patients and associated with a lower exercise capacity [1][2][3][4][5][6]. Indeed, the prevalence of anemia we observed (26%) is in agreement with what has been reported previously (between 10 and 55%) [4].…”

“…Indeed, the prevalence of anemia we observed (26%) is in agreement with what has been reported previously (between 10 and 55%) [4]. In HF the presence of anemia is associated with poor prognosis, with higher mortality risk both in hospitalized and ambulatory patients, higher hospitalization rate and, overall, with a more severe clinical condition for patients [4,[15][16][17]. In our study, on average, peak _ VO 2 and _ VE/ _ VCO 2 slope, both of which are independent strong prognostic indicators of HF [18], were 22% lower and 10% higher, respectively, in HF patients with anemia compared with those without anemia.…”

“…Anemia and reduction of exercise capacity are both frequently reported in chronic heart failure (HF) and are both associated to worsening of HF prognosis [1][2][3][4]. The two are linked to each other indirectly, having heart failure as a common underlying origin, and directly.…”

Ten-year survival and prognostic markers in one thousand patients with advanced heart failure. A single-centre analysis

“…Data on the prevalence of anaemia in chronic HF with low left ventricular ejection fraction range from 4 to 61% (ref. [8][9][10] ).…”

Pathogenesis of Anemia in Heart Failure

“…1,2 Although the mechanisms involved in the development of anemia in patients with heart failure are unclear, data suggest that renal dysfunction, neurohormonal, and proinflammatory cytokine activation in heart failure lead to anemia of chronic disease with defective iron utilization, inappropriate erythropoietin responsiveness, and depressed bone marrow function.…”