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Anaemia is associated with higher mortality among patients with heart failure with preserved systolic function
  1. L Grigorian Shamagian1,
  2. A Varela Roman1,
  3. J M Garcia-Acuña1,
  4. P Mazon Ramos1,
  5. A Virgos Lamela1,
  6. J R Gonzalez-Juanatey1
  1. Servicio de Cardiología y Unidad Coronaria, Hospital Clinico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
  1. Correspondence to:
    Dr Jose R González-Juanatey
    Servicio de Cardiología, Hospital Clínico Universitario, Travesía de A Choupana s/n, 15706 Santiago de Compostela, Spain; jose.ramon.gonzalez.juanatey{at}


Objective: To investigate the prevalence of anaemia and its influence on mortality among hospitalised patients with congestive heart failure (CHF) with preserved left ventricular systolic function (LVSF).

Method and results: 210 patients with preserved LVSF admitted to the cardiology department of a tertiary hospital for CHF between 1 January 2000 and 31 December 2002 were analysed. Anaemic patients, who constituted 46% of the whole group, were older (75 v 72 years, p  =  0.036); were in hospital longer (mean (SD) 13 v 11 days, p  =  0.007); had a higher prevalence of ischaemic heart disease (54% v 35%, p  =  0.009), left bundle branch block (12% v 4%, p  =  0.018), and kidney failure (56% v 34%, p  =  0.003); and had faster erythrocyte sedimentation rates (mean (SD) 50 v 26 mm in the first hour, p < 0.001), a tendency to lower serum cholesterol concentration (mean (SD) 4.65 v 5.22 mmol/l, p  =  0.073), and smaller body mass index (mean (SD) 27 v 29 kg/m2, p  =  0.126) than their non-anaemic counterparts. Kaplan-Meier analysis showed the anaemic group to have significantly poorer survival (p  = 0.0001), with a one year survival rate of 72.2% versus 90.5% in the non-anaemic group. Multivariate analysis showed anaemia to be the most powerful independent predictor of mortality, increasing the risk of death by a factor of 2.7 (p  =  0.007).

Conclusion: Anaemia is a very prevalent condition in hospitalised patients with CHF with preserved LVSF and is independently associated with higher mortality. Appropriately designed randomised studies are needed to determine whether the prevention or treatment of anaemia can improve survival of these patients.

  • CHF, congestive heart failure
  • CI, confidence interval
  • LVEF, left ventricular ejection fraction
  • LVSF, left ventricular systolic function
  • MDRD, modification of diet in renal disease
  • NYHA, New York Heart Association
  • SOLVD, studies of left ventricular dysfunction
  • anaemia
  • congestive heart failure
  • preserved systolic function
  • prognosis

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  • Published Online First 10 October 2005

  • Competing interests: None declared.