Implicaciones pronosticas de la Anemia en pacientes con Insuficiencia Cardiaca Aguda atendidos en Servicios de Urgencias Hospitalarios. Estudio ANEM-ICA.

INTRODUCTION The presence of 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 on 30-day and one-year mortality in patients with AHF attended in hospital emergency departments (HEDs). METHODS We performed a multicenter, observational study of prospective cohorts of patients with AHF. The study variables were: Anemia (hemoglobin <12g/dL in women and <13g/dL in men), mortality at 30 days 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, 7,662 (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-day 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 mortality at one year. The weight of anemia on mortality was different in each follow-up period. CONCLUSIONS Anemia is an independent predictor of mortality at 30 days 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.