Anemia Notably Impacts Heart Failure Prognosis, Study Finds

A new systematic review has pointed to the notable impact of anemia on the prognosis of heart failure (HF), demonstrating it as a reliable indicator of both short- and long-term all-cause mortality and HF events.¹

A comprehensive search was conducted in 4 major databases, including PubMed, Scopus, Web of Science, and ScienceDirect, and identified 10 relevant studies, with a total of 2,828 participants, for inclusion in the review.

“The current review highlights the significant association between anemia and prognosis in acute HF,” wrote the investigative team, led by Atheer A. Alshreef, internal medicine, University of Tabuk. “Anemia emerges not only as a common comorbidity in patients with HF but also as a potential prognostic marker.”

The coexistence of anemia and HF is common and often worsens each disease prognosis, the combination recognized in the literature to lower a patient’s overall health and quality of life.² Depending on its underlying etiology, treatment options for anemia in HF could include iron supplementation, erythropoiesis-stimulating medications, or blood transfusions.

Citing the lack of methodical studies evaluating this relationship, Alshreef and colleagues set out to address the potential connection between HF and anemia by systematically reviewing the existing literature to analyze the current findings and determine the need for further research.¹

Studies matching inclusion criteria were randomized controlled trials, cohort studies, case-control studies, or cross-sectional studies assessing the correlation between anemia and HF in human patient populations. Only studies published between 2023 and 2024 were considered eligible for inclusion.

The investigative team initially identified 1316 studies after removing duplicates. After evaluating titles and abstracts, and performing further screening processes, 10 studies met the eligibility requirements for the review. The patient population comprised 2,828 individuals, including 1451 (51.3%) males.

Most studies meeting inclusion criteria did not compare acute and chronic HF when assessing the prevalence and impact of anemia. Iron deficiency anemia (IDA) was the most prevalent type in the included studies, while 2 studies included megaloblastic anemia.

Anemia’s prevalence among individuals diagnosed with HF in the included studies ranged from 33.3% to 69.8%, with a total prevalence of 1643 (58.1%). Hypertension, diabetes, chronic kidney disease (CKD), and atrial fibrillation (AF) were the most commonly linked comorbidities in those with HF.

Alshreef and colleagues identified a correlation between anemia and B-type natriuretic peptide (BNP), renal function, increased left cardiac remodeling, and increased plasma volume expansion.

Overall, the analysis showed patients with anemia had a notably higher mortality risk, compared with patients without anemia. However, anemia was a marker of disease severity, rather than an independent predictor of death in congestive individuals. Anemia was notably linked to elevated serum creatinine, left ventricular hypertrophy, and left atrial enlargement.

Alshreef and colleagues called for further research into the effect of anemia on the progression of HF, particularly to identify effective interventions for anemia management. In particular, the investigative team addressed the need to explore the effectiveness of available anemia treatments on a patient’s prognosis.

“Recognizing the link between anemia and negative outcomes in acute HF could facilitate more personalized treatment approaches that target both issues,” they wrote. “Future research is essential to better understand how anemia affects the progression of HF and its complications.” 

References

1. _{Mirghani H, Alshreef AA, Al-Temani HA, et al. Updates on the Association Between Anemia and Heart Failure: A Systematic Review. Cureus. 2024;16(9):e69101. Published 2024 Sep 10. doi:10.7759/cureus.69101}
2. _{Siddiqui SW, Ashok T, Patni N, Fatima M, Lamis A, Anne KK. Anemia and Heart Failure: A Narrative Review. Cureus. 2022;14(7):e27167. Published 2022 Jul 23. doi:10.7759/cureus.27167}