Clinical manifestations of anemia syndrome and its significance in the course of chronic heart failure in elderly patients

To define the practical significance of anemia in the course of chronic heart failure (CHF) in elderly outpatients. One hundred and sixty-four patients aged 60 to 85 years with NYHA classification Functional Class (FC) II--IV CHF due to coronary heart disease and arterial hypertension were examined. Clinical, laboratory, and echocardiographic parameters were assessed; admissions and fatal outcomes were recorded. The follow-up was 2.5 +/- 2.1 years. Anemia syndrome was recorded in 32.9% of the patients (women were 43.5% and men were 26.5%) (p = 0.024). There was an association between decreased hemoglobin levels and renal dysfunction (odds ratio (OR) 2.04; 95% confidence interval, 1.05 to 3.98; p = 0.036). In all the patients, anemia was mild and similar in its pattern and etiology, regardless of gender. Because of decompensated CHF, 46.3% of the patients with anemia and 22.7% of those without this condition were admitted to hospital (p = 0.002). The survival rates of the elderly CHF patients with and without anemia were equal (p = 0.549); however, comparison of only the patients with anemia showed a difference in male and female survival rates (p = 0.005). FC III--IV CHF (OR 4.37), chronic kidney disease (OR 2.27%), and a left ventricular ejection fraction of < 35% (OR 2.74) were predictors of a poor outcome in the elderly patients with CHF and anemia. Anemia was encountered in 32.9% of the elderly outpatients with CHF. Anemia was more common in the women than in the men and mild and similar in its pattern and etiology, regardless of gender. The disease prognosis was more favorable in the females than in the males.