Anaemia and iron deficiency may adversely affect people with heart failure

11th July 2016

Anaemia and iron deficiency in long-standing (chronic) heart failure is associated with increased mortality, a British study has showed.

Among patients referred to an outpatient clinic for suspected heart failure, 27.8% were anaemic.  Dr George Cleland, from the University of Hull, and colleagues reported online in the Journal of the American Medical Association.

And the proportion with anemia was higher in those diagnosed with heart failure. The proportion with iron deficiency was 75.5%.

Researchers said the results also demonstrated a link with higher rates of a mortality from all causes, but mostly driven by heart disease.

Anaemia, regardless of its cause, increased cardiac demand, which could have a damaging effect on symptoms and prognosis, they said.  Iron deficiency might also be important in heart failure.

It was likely that both the severity of anemia and iron deficiency contributed to a worse outcome in patients with heart failure. So both problems provided potential treatment targets.

A total of 4,456 people recruited for the study had been referred to a community outpatient clinic because of suspected heart failure. They had an average age 73 and six in ten were men.

They were completed a questionnaire, and had a clinical examination, an ECG and echo. Patients were tracked by electronic records for up to ten years; but all but 294 patients were followed up for at least three years.

While specific causes of anemia were difficult to identify, the researchers offered a few possibilities. These included worsening congestion, kidney dysfunction leading to reduced red blood cell mass, and poorer nutrition. Some medication for heart failure might also be involved.

It is hoped the results can be used to help researchers start clinical trials for treating anemia, iron deficiency, or both through specific interventions.

For more details, see here