RESEARCH ARTICLE


Anaemia and Long Term Mortality in Heart Failure Patients: A Retrospective Study



Mette Charlot1, *, Christian Torp-Pedersen1, Nana Valeur1, Marie Seibæk2, Peter Weeke1, Lars Køber3
1 Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark
2 Department of Cardiology, Glostrup Hospital, University of Copenhagen, Denmark
3 The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Denmark


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© Charlot et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Cardiology, Copenhagen University Hospital Gentofte, PA Forskning, Post 67, Niels Andersens Vej 65, 2900 Hellerup, Denmark; Tel: +45 39978717; Fax: + 4570201281; E-Mail: mc@heart.dk


Abstract

Background:

Anaemia has been demonstrated as a risk factor in patients with heart failure over periods of a few years, but long term data are not available. We examined the long-term risk of anaemia in heart failure patients during 15 years of follow-up.

Methods:

We evaluated survival data for 1518 patients with heart failure randomized into the Danish Investigations of Arrhythmia and Mortality on Dofetilide (DIAMOND) trial. The follow-up time was from 13 to 15 years. After 15 years 11.5% of the patients were still alive.

Results:

Anaemia was present in 34% of the patients. 264 (17%) had mild, 152 (10%) had moderate and 98 (7%) had severe anaemia. Hazard ratio of death for patients with mild anaemia compared with patients with no anaemia was 1.27 (1.11-1.45, p<0.001), for moderate anaemia 1.48 (1.24-1.77, p<0.001) and for severe anaemia 1.82 (1.47-2.24, p<0.001), respectively. In multivariable analyses anaemia was still associated with increased mortality with hazard ratios of 1.19 (1.04–1.37, p=0.014) for mild anaemia, 1.23 (1.03–1.48, p=0.024) for moderate anaemia and 1.33 (1.07–1.66, p=0.010) for severe anaemia, respectively. In landmark analysis the increased mortality for mild anaemia was only significant during the first 2 years, while moderate anaemia remained significant for at least 5 years. There were too few patients left with severe anaemia after 5 years to evaluate the importance on mortality beyond this time.

Conclusion:

Anaemia at the time of diagnosis of heart failure is an independent factor for mortality during the following years but loses its influence on mortality over time.

Keywords: Anaemia, heart failure, mortality. .