Clinical Analysis Of Anemia Associated With Hospitalized Heart Failure In China

Objective: To analyze the incidence and risk factors of anemia in hospitalized patients with heart failure by cross-sectional study in China.Methods: Using the national multi-center registration method,collected the clinical data of patients with heart failure from 19 city 45 hospitals in our country,according to the ejection fraction of patients were divided into HFpEF group(LVEF>40%)and HFr EF group(LVEF?40%),Male Hb<120g/L and female Hb<110g/L were defined as anemia,and compared the clinical data between anemia group and non-anemia group,calculated the prevalence of anemia.Multivariate Logistic regression analysis was used to explore the risk factors of anemia.Results:1.(1)A total of 5040 patients with CHF were included in this study,of which 3028(60.1%)were male and 2012(39.9%)for women.The average age was 70 + 13 years,the average hemoglobin level was 126 + 24 g/L,and the patients over 65 years old accounted for 67.1%.(2)1298 cases of CHF anemia,the total prevalence rate was 25.8%,among which the prevalence of anemia in HFrEF patients and HFpEF patients was(21.9% vs 26.9%,p<0.001);(3)Compared with non-anemia group,patients with anemia were older(74 VS 68 years old),diastolic blood pressure(75 VS 79 mmHg),low body mass index(23.6 VS 24.0 kg/m2),and high serum creatinine(96 VS 83 ?mmol/L),high blood urea nitrogen(8 VS 6 mmol/L),high serum uric acid(388 VS 379 ?mmol/L),high NT-proBNP level(2472 VS 1126 pg/ml),low serum sodium(140 VS 141 mmol/L)and length of stay in hospital(11 VS 10 days);Among complications,anemia patients had more hypertension(64.6% VS 60.9%),diabetes(27.4% VS 22.5%),and arrhythmia(50.5 % VS 43.8%),valvular disease(26.2% VS 19.8%),chronic renal insufficiency(20.5% VS 5.4%).(p<0.05)2.(1)The constituent ratios of NYHA functional class I,II,III and IV in the anemic and non-anemia groups were 2.9%,30.1%,48.0%,19.0% and 5.4%,41.4%,40.0%,and 13.2%,respectively.NYHA functional class was higher in the anemia group than in the non-anemia NYHA class(p< 0.001);of heart function,the proportion and severity of anemia in patients with heart failure are also gradually increasing.The proportion of combined anemia inclass I,II,III,and IV is 15.5%,20.1%,29.4%,and 33.3%,respectively(p<0.001),mean hemoglobin was 134 g/L,128 g/L,124 g/L,and 122 g/L,respectively(p<0.001).3.Both HFrEF and HFp EF patients,compared with non-anemia group,patients with anemia have older age,lower diastolic blood pressure,renal insufficiency(creatinine,blood urea nitrogen,blood uric acid),high NT-proBNP,long hospitalization days,less use of ACEI or ARB drugs(p< 0.05);however,in clinical complications,hypertension,coronary heart disease is only associated with HFrEF anemia,while diabetes and valvular heart disease are only associated with HFpEF anemia.4.Multivariate Logistic regression analysis found that in patients with HFrEF,age(OR=1.408,95%CI[1.252-1.584]),serum creatinine level(OR=1.316,95%CI[1.177-1.471])were anemia.Risk factors,and increased diastolic blood pressure(OR=0.780,95% CI [0.668-0.911])are protective factors;in patients with HFpEF,age(OR=1.371,95% CI [1.238-1.518]),blood Increased creatinine(OR=1.481,95%CI[1.320-1.661])and NYHA functional class(OR=1.351,95%CI[1.044-1.749])were all risk factors for anemia,whereas diastolic bloodpressure levels increased(OR = 0.780,95% CI [0.668-0.911])is its protective factor?Conclusions:(1)Patients with HFrEF or HFpEF have more than one-fifth of patients with anemia;(2)The prevalence and severity of anemia associated with CHF patients gradually increase with the deterioration of NYHA heart function;(3)Anemic patients have the characteristics of older age,low body mass index,low diastolic blood pressure,poor NYHA cardiac function,poor renal function,high NT-proBNP,and long hospital stay than non-anemia patients.In comorbidities,anemia patients are often complicated by hypertension,diabetes,arrhythmia,valvular heart disease,and chronic renal insufficiency,treatment is less commonly used ACEI or ARB drugs and beta blockers,and more diuretics;(4)Multivariate logistic regression analysis found that in HFrEF In patients with HFpEF,age and increased serum creatinine are all risk factors for anemia.NYHA heart function deterioration is only a risk factor for anaemia in patients with HFpEF?...