Evaluation and Long-Term Prognosis of New-Onset, Transient, and Persistent Anemia in Ambulatory Patients With Chronic Heart Failure

Abstract

Objectives: This study sought to determine the characteristics and long-term prognosis of anemia in ambulatory patients with chronic heart failure. Background: Anemia is prevalent in heart failure and may portend poor outcomes. Methods: We reviewed 6159 consecutive outpatients with chronic stable heart failure at baseline, shortterm (3-month) follow-up, and longterm (6-month) follow-up between 2001 and 2006. Clinical, demographic, laboratory, and echocardiographic data were reviewed from electronic medical records. Mortality rates were determined from 6-month follow-up to end of the study period. Results: Prevalence of anemia (hemoglobin <12 g/dL for men, <11 g/dL for women) was 17.2% in our cohort. Diabetes, B-natriuretic peptide, left ventricular ejection fraction, and estimated glomerular filtration rate were independent predictors of baseline anemia. Documented evaluation of anemia was found in only 3% of all anemic patients and better in internal medicine than in cardiology clinics. At 6-month followup, new-onset anemia developed in 16% of patients without prior anemia, whereas 43% patients with anemia at baseline had resolution of their hemoglobin levels. Higher total mortality rates were evident in patients with persistent anemia (58% vs 31%; P