Anaemia worsens outcome after heart attack in patients with heart failure

MedWire News: Anaemia, where haemoglobin levels in the blood are too low, signals a poor outcome in heart attack patients who develop heart failure, a large study suggests.

“The prevalence, incidence, and prognostic value of anaemia in patients with an acute myocardial infarction [heart attack] complicated by heart failure is unclear,” say Dr Adriaan Voors (University of Groningen, The Netherlands) and colleagues.

To investigate, Dr Voors and team analysed the relationship between haemoglobin levels and outcome in 5010 patients who had suffered a heart attack and developed signs and symptoms of heart failure.

The researchers report that 28% of the patients had anaemia, defined as a haemoglobin level of less than 12 g/dl for women and less than 13 g/dl for men, at the time of their heart attack.

Patients with low haemoglobin levels were more likely to be female and older, to have diabetes, have more severe heart failure, have high blood pressure and cholesterol levels and to be smokers than those with normal levels of haemoglobin.

Dr Voors’s team found that higher levels of haemoglobin were associated with lower risks of mortality, being admitted to hospital due to heart failure and admission to hospital for any reason up to 3 years after the heart attack.

Among patients without anaemia at the start of the study, around 10% had developed anaemia 1 year later, while 65% of those with anaemia at the start of the study did not have it at 1 year and 46% did not at any time during follow-up.

Of note, an increase in haemoglobin at 1 year was associated with improved survival.

Dr Voors and co-authors conclude: “Studies are warranted to determine whether correcting anaemia after a complicated acute myocardial infarction improves outcome.”

The study findings are published in the European Heart Journal.