Anemia Linked to Heart Failure Death By Paula Rasich Reviewed by Elizabeth Klodas, MD, FACC (CardioSmart) Anemia is a risk for many heart failure patients, according to a new meta-analysis of 34 peer-reviewed studies.

Anemia, or a low red blood-cell count, occurs in about one third of all heart failure patients. The condition can be caused by an iron or vitamin deficiency, internal bleeding, blood loss, chronic inflammatory conditions or kidney failure. In some cases, anemia can be a side effect of medication use.

To investigate the relationship between anemia and risk of death in people with chronic heart failure, Peter van der Meer, MD, PhD, and colleagues from the University Medical Center Groningen in the Netherlands and elsewhere, collected data on more than 150,000 heart failure patients, of whom 37.2% were identified as anemic.

All studies included in the meta-analysis were at least six months in duration. The findings showed that 46.8% of anemic patients died versus 29.5% of non-anemic patients. Researchers found that anemic heart failure patients had a twofold higher risk of dying than those without anemia.  In addition, after accounting for age, medication use, and other heart risk factors, they found that those with anemia were nearly 50% more likely to die than those who had not developed the condition.  

“This study makes it clearer that anemia is an independent risk factor for mortality in heart failure patients,” says Dr. van der Meer, who is also a visiting scientist at Massachusetts General Hospital in Boston.  “We also observed that it doesn’t matter whether you have systolic or diastolic heart failure because both forms of heart failure were associated with an increased risk of mortality with anemia.”  

Treatments for anemia may include iron therapy or erythropoietin (ee-reth-ro-po-EAT-in), a hormone that stimulates production of hemoglobin, the oxygen-carrying protein in red blood cells. As yet, it’s not clear that treating anemia improves survival rates. Currently, studies are underway to see if correcting anemia will have an affect on disease progression and death rates in heart failure patients, says Dr. van der Meer.

This study was published in the September 2, 2008 issue of the Journal of the American College of Cardiology.

Sources:

Groenveld HF et al.  Anemia and Mortality in Heart Failure Patients. A Systematic Review and Meta-Analysis.  Journal of the American College of Cardiology, 2008.

Peter van der Meer, MD, PhD, Visiting Scientist, Massachusetts General Hospital, Boston, Massachusetts.