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The link between chronic heart failure and anemia: Insights from clinical practice

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Background: Anemia is a frequent comorbidity in patients with chronic heart failure. The objective of the study was to evaluate the frequency of anemia and the clinical and paraclinical characteristics of patients with decompensated chronic heart failure admitted to the Internal Medicine Clinic of the Clinical Emergency Hospital of Bucharest, Romania, over a period of 6 months.

Methods: Between December 1st, 2014 and May 1st, 2015, the total number of admissions with the diagnosis of decompensated chronic heart failure was 309. From these, 78 patients had anemia (25.24%) and represented our group of study. We retrospectively analyzed the data from the hospital medical records database.

Results: The majority of patients had mild anemia (64%). Only one patient had severe anemia (2%), all the others having moderate anemia (34%). 64% of patients had normocytic hypochromic anemia, 21% had microcytic hypochromic anemia, 8% normocytic normochromic anemia and 7% had other forms of anemia. The distribution of chronic heart failure by NYHA class at admission was: 47% of patients had NYHA class IV, 37% had NYHA class III and only 16% were in NYHA class II.

Conclusions: In our study, 25% of the chronic heart failure patients had anemia, most often associated with chronic kidney disease. In the majority of the cases, patients with chronic heart failure presented anemia typical for chronic diseases (normocytic anemia), much rarely microcytic anemia. Our data did not prove a statistical correlation between the anemia severity and age of the patients or severity of chronic heart failure, evaluated by NYHA class.

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