ผลกระทบของภาวะโลหิตจางต่อผลลัพธ์การรักษาผู้ป่วยหัวใจล้มเหลวเรื้อรัง
Keywords:
Anemia, chronic heart failure, CHF, underproductive anemia, renal anemiaAbstract
Abstract:
Background: Anemia is frequently observed among patients with chronic heart failure (CHF) and may cause adverse effects. The primary objective was to study the effects of anemia on the composite endpoint (hospitali-zation and mortality) among patients with CHF. Methods: This was a prospective case control study recruiting patients with a CHF diagnosis and followed up in the heart failure clinic. The patients were classified in 2 groups using the WHO criteria of anemia and followed up for 12 months. For anemic patients, the causes of anemia were evaluated and corrected whenever possible. Results: The study enrolled 100 patients with CHF, 49 patients with anemia, and 51 patients with normal hemoglobin (Hb). The median ages among anemic and non-anemic patients were 68 and 58 years, respectively. Mean Hb among patients with and without anemia were 10.4 (7.1-12.8) g/dL and 13.7 (12.0-16.8) g/dL, respectively (p < 0.001). Mean ejection fraction between the 2 groups were comparable (33.2 vs. 31.9%, p = 0.65). The majority of patients (79.5%) had underproductive anemia, commonly from multifactorial factors (40.9%). The 1-year event-free survival (EFS) rates among anemic and non-anemic patients were 34.7% and 66.7%, respectively (p = 0.02). From Cox-regression analysis, the anemia (hazard ratio [HR] 2.01, 95%CI: 1.09-3.77, p = 0.018) and NYHA 3-4 (HR 1.76, 95%CI: 1.01-3.31, p = 0.044) were associated with poor EFS. Conclusion: Anemia adversely affected outcomes including hospitalization and survival among patients with CHF. Therefore, the causes of anemia should be investigated and corrected.
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