Prevalence and factors affecting anemia among patients with chronic heart failure with reduced or mildly reduced ejection fraction, Samutsakorn Hospital
Keywords:
Chronic heart failure with reduced and mildly reduced ejection fraction, anemia, iron deficiency, New York Heart Association functional classAbstract
Background: Anemia is one of major co-morbidities in patients with chronic heart failure with reduced and mildly reduced ejection fraction (HFrEF & HFmrEF) and may deteriorate patients with these conditions.
Objective: To analyze and compare prevalence and factors affect anemia in patients with chronic HFrEF & HFmrEF categorises based on New York Heart Association (NYHA) functional class 1-2 with NYHA functional class 3-4.
Methods: This was a retrospective chart review with consecutive data collection of patients diagnosed with chronic HFrEF & HFmrEF in Samutsakorn Hospital during 1st July 2021 – 31st December 2022. Patients included in this study must receive hemoglobin level test and had documented of follow up data after initial treatment. A multivariable logistic regression model was used to determine the factors affecting the effect of anemia in these patients, and the results of analysis were presented with an odds ratio and 95% confidence interval.
Results: A total of 391 patients were met an inclusion criterion in this study. The prevalence of anemia in patients with chronic HFrEF and HFmrEF was 52%. Only 15 % of patients in our study received iron study and serum ferritin testing. Patients with chronic HFrEF and HFmrEF with NYHA class 3-4 had a prevalence of anemia at 71.95 %, significantly more than NYHA class 1-2, which was 46.92% (p < 0.001). NYHA class 3-4 (Adj.OR 2.32, 95%CI: 1.22-4.43, p = 0.010), female (Adj.OR 2.38, 95%CI: 1.37-4.14, p = 0.002), low BMI (Adj.OR 4.71, 95%CI: 1.64-13.57, p = 0.004), diabetes mellitus (Adj.OR 2.44, 95%CI: 1.42-4.17, p = 0.001) and serum creatinine (Adj.OR 2.08, 95%CI: 1.37-3.15, p = 0.006) were predictive factors associated with anemia in patients with chronic HFrEF & HFmrEF. Whereas low DBP (Adj.OR 0.97, 95%CI: 0.96-0.99, p = 0.006) was less likely to be associated with anemia in patients with chronic HFrEF & HFmrEF.
Conclusion: Anemia has significant higher prevalence in chronic HFrEF & HFmrEF patients with a worsening functional class. Thus, identification of the etiology and treatment of anemia are needed in these patients.
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