European Journal of Molecular & Clinical Medicine

Abstract

Introduction: Anemia is a common finding in patients with heart failure (HF). The cause for anemia is multifactorial, with iron deficiency being the most common cause. Anemia with HF is an established predictor of morbidity and mortality. Iron deficiency in systolic HF, even without anemia, has been associated with increased mortality, increased hospitalizations, and decreased functional capacity and quality of life measures.
Methods: The current study was done  at the sri jayadeva institute of cardiovascular sciences hospital, Kalaburagi, Karnataka  over a period of 2 years from march 2016-2018. We evaluated ID in heart failure patients. ID was defined as absolute (ferritin < 100 μg/L) or functional (transferrin Saturation index < 20% and ferritin between 100 and 299 μg/L). We evaluated if ID was a predictor of death or hospitalization due to heart failure or any cause using univariate and multivariate cox regression analysis.
Results: There were 67.5% (27/40) patients who had ID with a mean serum ferritin level of 76.4 μg/L. Of the 27 iron deficient patients, 22 (55%) had an absolute ID, and 5 had a functional ID. Eight out of 27 of the iron deficient patients were anemic (20% of the total cohort, 30% of the iron deficient patients). Anemia was seen in 6 other patients, which was possibly anemia of chronic disease. There was a trend for more advanced New York Heart Association (NYHA) class (NYHA III and NYHA IV) patients with ID (37.4% vs. 30.77%, P = 0.697).
Conclusion: Anaemia is a very common comorbid condition in patients of HF. The pathophysiology is diverse and includes nutritional deficiencies, loss of blood through GI tract, decreased iron absorption, and decreased release of stored iron. It is an independent predictor of reduced exercise capacity, quality of life, and recurrent hospitalizations.