The prognostic value of anemia in patients with diastolic heart failure

Anemia is prevalent in heart-failure patients, and it has been associated with increased mortality rates. In a retrospective study, we evaluated the effects of anemia on long-term survival in patients who experienced purely diastolic heart failure. Heart-failure patients with preserved systolic function (left ventricular ejection fraction, ≥0.50) were evaluated retrospectively. Of 294 patients, 162 had anemia (group 1) and 132 had no anemia (group 2) upon baseline examination. Anemia was defined as a hemoglobin level below 12 g/dL in women and below 13 g/dL in men. Multivariate Cox proportional hazards regression was conducted in order to test whether hemoglobin levels were an independent predictor of 5-year hospitalization and mortality rates in patients with diastolic heart failure. A P value less than 0.05 was considered statistically significant. Group 1 patients had a shorter mean survival time (37.8 ± 1.8 vs 44.9 ± 1.8 mo, P=0.01); however, there was no significant difference between the groups in hospitalization rate (7.2 ± 7.1 vs 7.5 ± 6.3, P=0.677). In a subgroup analysis, anemia was a significant predictor of higher mortality rates in elderly patients (age, >75 yr) who had diastolic heart failure (P=0.018). We found that anemia is associated with increased long-term mortality rates in patients who have diastolic heart failure. In addition, anemia appears to be an independent predictor of worse outcomes in elderly heart-failure patients.