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Prognostic implications of Anemia in patients with Acute Heart Failure in emergency departments. ANEM-AHF Study.
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  • Angeles Fernández-Rodriguez,
  • Belén Prieto-García,
  • Joaquín Vázquez-Álvarez,
  • Javier Jacob,
  • Victor Gil,
  • Òscar Miró,
  • Pere Llorens,
  • Francisco Javier Martín-Sánchez,
  • Aitor Alquezar,
  • Pilar López-DíezOrcid,
  • Esther Rodríguez-Adrada,
  • Rodolfo Romero-Pareja,
  • Pablo Herrero-Puente
Angeles Fernández-Rodriguez
Hospital Universitario Central de Asturias
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Belén Prieto-García
Hospital Universitario Central de Asturias
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Joaquín Vázquez-Álvarez
Hospital Universitario Central de Asturias
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Javier Jacob
Hospital Universitari de Bellvitge
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Victor Gil
Hospital Clinic de Barcelona
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Òscar Miró
Hospital Clinic de Barcelona
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Pere Llorens
Alicante General University Hospital
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Francisco Javier Martín-Sánchez
Hospital Clínico San Carlos
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Aitor Alquezar
Hospital de la Santa Creu i Sant Pau
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Pilar López-Díez
Orcid
Hospital Universitario de Burgos
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Esther Rodríguez-Adrada
Hospital Universitario Rey Juan Carlos
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Rodolfo Romero-Pareja
Hospital Universitario de Getafe
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Pablo Herrero-Puente
Hospital Universitario Central de Asturias
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Peer review status:UNDER REVIEW

11 Jul 2020Submitted to International Journal of Clinical Practice
13 Jul 2020Assigned to Editor
13 Jul 2020Submission Checks Completed
13 Jul 2020Reviewer(s) Assigned
28 Jul 2020Review(s) Completed, Editorial Evaluation Pending

Abstract

INTRODUCTION: The anemia leads to a worse prognosis in patients with heart failure(HF). There are few data on the impact of anemia on mortality in patients with acute heart failiure(AHF), and the studies available are mainly retrospective and include hospitalized patients. OBJECTIVE. Evaluate the role of anemia in 30-days and one-year mortality in patients with AHF attended in hospital emergency departments(HEDs). METHODS. Multicenter, observational study of prospective cohorts of patients with AHF. Study variables: anemia(hemoglobin<12g/dL in women and <13g/dL in men), 30-days-mortality and at one year, risk factors, comorbidity, functional impairment, basal functional grade for dyspnea, chronic and acute treatment, clinical and analytical data of the episode and patient destination. Statistical analysis: bivariate analysis and survival analyses using Cox regression. RESULTS. A total of 13,454 patients were included, 7662(56.9%) of whom had anemia. Those with anemia were older, had more comorbidity, a worse functional status and New York Heart Association class, greater renal function impairment and more hyponatremia. The mortality was higher in patients with anemia at 30-days and one-year: 7.5% vs. 10.7%(p<0.001) and 21.2% vs. 31.4%(p<0.001), respectively. The crude and adjusted hazard ratios of anemia for 30-days-mortality were: 1.46(confidence interval[CI]95% 1.30-1.64);p<0.001 and 1.20(CI95% 1.05-1.38);p=0.009, respectively, and 1.57(CI95% 1.47-1.68) and 1.30(CI95% 1.20-1.40) for one-year-mortality. The weight of anemia on mortality was different in each follow-up period. CONCLUSIONS. Anemia is an independent predictor of 30-days-mortality and one year in patients with AHF attended in HEDs. It is important to study the etiology of AHF since adequate treatment would reduce mortality.