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Anaemia A Marker For Higher Mortality Among Elderly With Heart Failure

Anaemia is associated in older patients with an increased risk of death among those with heart failure, say researchers in the United States.

What is still not clear, however, is whether the anaemia is a direct cause of worsened outcomes, or if it is a marker for other causal factors, say the investigators at the Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut.

There is the suggestion in previous studies that anaemia could adversely affect cardiovascular conditions among patients with heart failure, they add, but the prognostic importance of this treatable condition is still not well established.

The investigators studied a cohort of 2,281 patients, aged 65 and older (mean age 79), who had been admitted to hospital with heart failure. The researchers sought to determine the prognostic value of hematocrit levels. Multivariate Cox proportional hazards regression was used to test whether hematocrit level was an independent predictor of mortality after one year, and readmission of patients to hospital.

It was found that lower hematocrits were associated with a higher mortality among the cohort. Adjusted for demographic and clinical factors, each 1% lower hematocrit was associated with a 2% greater mortality at one year.

Compared with patients with a hematocrit over 42%, patients with a hematocrit less than, or equal to, 27%. had a 40% greater one year mortality. This increased risk was similar to that conferred by traditional risk factors, including a left ventricular ejection fraction equal to, or less than, 20%.

Lower hematocrits were also associated with a greater risk of readmission to hospital.
Am J Med 2003 Feb;114:2:112-9. "The prognostic importance of anemia in patients with heart failure."

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