Chapter

Anaemia

Peter van der Meer and Dirk J. van Veldhuisen

in Oxford Textbook of Heart Failure

Published on behalf of Oxford University Press

ISBN: 9780199577729
Published online July 2011 | e-ISBN: 9780199697809 | DOI: http://dx.doi.org/10.1093/med/9780199577729.003.0028

Series: Oxford Textbooks

Anaemia

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In patients with chronic heart failure (HF), anaemia is frequentlydiagnosed. The prevalence of anaemia depends on the severity ofheart failure and the diagnostic criteria used to define it. The criteriaof the World Health Organization (haemoglobin <12 g/dL(7.5 mmol/L) in women, haemoglobin <13 g/dL (8.1 mmol/L) inmen) are most commonly used in the majority of studies appearingon the topic. Recently a study was performed in 2653 patientsrandomized in the CHARM Program. This substudy revealed thatanaemia was equally common in patients with CHF and preserved (27% ) or reduced (25% ) left ventricular ejection fraction (LVEF).The presence of anaemia was associated with diabetes, low bodymass index, higher systolic and lower diastolic blood pressure, andrecent heart failure (HF) hospitalization. In the study, more thanone-half of the anaemic patients had impaired renal function(glomerular filtration rate <60 mL/min), compared with less than30% of the nonanaemic chronic HF patients. In 2008, a meta-analysiswas conducted to address the relationship between anaemiaand mortality in patients with chronic HF. In this analysis,examining more than 150 000 patients, anaemia was frequentlyobserved, being found in over one-third of the chronic HF patients.The presence of anaemia was associated with a doubled mortalityrisk in patients with systolic as well as diastolic HF.When assessing the mortality risk by using multivariate analyses,anaemia remained an independent risk factor for mortality in chronic HF patients. The incidence of anaemia is much more difficult to determinethan the prevalence. Data from the OPTIMAAL trial suggest,though, that in a population without anaemia at baseline who hada heart attack complicated by the development of HF, the incidence of anaemia was 10% in the first year.

Chapter.  4724 words.  Illustrated.

Subjects: Cardiovascular Medicine

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