Managing anemia in patients with chronic heart failure: what do we know?

Review

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Authors: Ankur Sandhu, Sandeep Soman, Michael Hudson, et al

Published Date April 2010 Volume 2010:6 Pages 237 - 252

DOI: http://dx.doi.org/10.2147/VHRM.S4619

Ankur Sandhu¹, Sandeep Soman¹, Michael Hudson², Anatole Besarab¹

¹Divisions of Nephrology, ²Cardiology, Henry Ford Health System, Detroit, Michigan, USA

Abstract: Anemia is common in patients with chronic heart failure (HF) with an incidence ranging from 4% to 55% depending on the studied population. Several studies have highlighted that the prevalence of anemia increases with worsening heart failure as reflected by New York Heart Association classification. Additionally, several epidemiological studies have highlighted its role as a prognostic marker, linking it to worse outcomes including; malnutrition, increased hospitalizations, refractory heart failure and death. The pathophysiology of anemia is multifactorial and related to various factors including; hemodilution, iron losses from anti-platelet drugs, activation of the inflammatory cascade, urinary losses of erythropoietin and associated renal insufficiency. There are a host of epidemiological studies examining HF outcomes and anemia, but only a few randomized trials addressing this issue. The purpose of this article is to review the literature that examines the interrelationship of anemia and congestive HF, analyzing its etiology, impact on outcomes and also the role of associated kidney disease as well as cardiorenal syndrome both as a marker of morbidity and mortality.

Keywords: anemia, cardio-renal syndrome, heart failure