Cardoso Juliano, Brito Michel Ibrahim, Ochiai Marcelo Eidi, Novaes Milena, Berganin Fabrício, Thicon Tatiana, Ferreira Elaine C, Regina Kelly, Reis Cristina Martins Dos, Barretto Antonio Carlos Pereira
Hospital Cotoxó InCor, FMUSP, São Paulo, SP, Brasil.
Arq Bras Cardiol. 2010 Oct;95(4):524-8. doi: 10.1590/s0066-782x2010005000118. Epub 2010 Sep 3.
anemia is linked with worsening of progress in patients with heart failure (HF). However, there are few studies of anemia in patients with advanced HF.
to evaluate the characteristics of anemia in HF at an advanced stage.
the study included 99 patients, aged > 18 and LVEF < 45%, who were hospitalized for HF compensation (FC IV/NYHA). Patients with hemoglobin (Hb) levels < 12 g/dl were considered anemic. Data on anemic and nonanemic patients were compared. The Student's t-test, Chi-square test and Fisher test were used. The relative risk (HF 95%) was calculated by the Cox regression.
on average, the patients were monitored for 10.8 months (8.9), and 34.3% of patients with HF had anemia. On average, in comparison with nonanemic patients, anemic patients were older (64.1 ± 15.6 versus 54.8 ± 12.9 years old, p = 0.004), their creatinine level was higher (1.9 ± 1 versus 1.5 + 0.5 mg/dl, p = 0.018) and their BNP level was also higher (2,077.4 ± 1,979.4 versus 1,212.56 ± 1,080.6 pg/ml, p = 0.026). 38.24% of the anemic patients had iron deficiency anemia. After there was an improvement in the congestion, only 25% of patients with anemia were discharged with Hb > 12 g/dl. Anemia was an independent marker of poor prognosis in the multivariate analysis (mortality of 47% vs 24.6%, p = 0.016, relative risk of 2.54).
anemia affects approximately one third of patients with advanced HF, and iron deficiency is an important etiology. Anemic patients are older their renal function was more deteriorated. The improvement in the congestion was not enough to improve the anemia in most cases. In patients with advanced HF, anemia is an independent marker of poor prognosis.
贫血与心力衰竭（HF）患者病情进展恶化有关。然而，关于晚期HF患者贫血的研究较少。
评估晚期HF患者贫血的特征。
该研究纳入了99例年龄>18岁且左心室射血分数（LVEF）<45%、因HF失代偿（FC IV/NYHA）住院的患者。血红蛋白（Hb）水平<12 g/dl的患者被视为贫血。对贫血患者和非贫血患者的数据进行比较。采用学生t检验、卡方检验和费舍尔检验。通过Cox回归计算相对风险（HF 95%）。
患者平均随访10.8个月（8.9），34.3%的HF患者患有贫血。平均而言，与非贫血患者相比，贫血患者年龄更大（64.1±15.6岁对54.8±12.9岁，p = 0.004），肌酐水平更高（1.9±1对1.5 + 0.5 mg/dl，p = 0.018），脑钠肽（BNP）水平也更高（2077.4±1979.4对1212.56±1080.6 pg/ml，p = 0.026）。38.24%的贫血患者患有缺铁性贫血。充血情况改善后，只有25%的贫血患者出院时Hb>12 g/dl。在多变量分析中，贫血是预后不良的独立标志物（死亡率47%对24.6%，p = 0.016，相对风险2.54）。
贫血影响约三分之一的晚期HF患者，缺铁是一个重要病因。贫血患者年龄更大，肾功能更差。在大多数情况下，充血情况的改善不足以改善贫血。在晚期HF患者中，贫血是预后不良的独立标志物。
