Clinical manifestations of anemia syndrome and its significance in the course of chronic heart failure in elderly patients


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AIM: To define the practical significance of anemia in the course of chronic heart failure (CHF) in elderly outpatients/MATERIAL AND METHODS: One hundred and sixty-four patients aged 60 to 85 years with NYHA classification Functional Class (FC) II-IV CHF due to coronary heart disease and arterial hypertension were examined. Clinical, laboratory, and echocardiographic parameters were assessed; admissions and fatal outcomes were recorded. The follow-up was 2.5±2.1 years/RESULTS: Anemia syndrome was recorded in 32.9% of the patients (women were 43.5% and men were 26.5%) (p=0.024). There was an association between decreased hemoglobin levels and renal dysfunction (odds ratio (OR) 2.04; 95% confidence interval, 1.05 to 3.98; p=0.036). In all the patients, anemia was mild and similar in its pattern and etiology, regardless of gender. Because of decompensated CHF, 46.3% of the patients with anemia and 22.7% of those without this condition were admitted to hospital (p=0.002). The survival rates of the elderly CHF patients with and without anemia were equal (p=0.549); however, comparison of only the patients with anemia showed a difference in male and female survival rates (p=0.005). FC III-IV CHF (OR 4.37), chronic kidney disease (OR 2.27%), and a left ventricular ejection fraction of <35% (OR 2.74) were predictors of a poor outcome in the elderly patients with CHF and anemia/CONCLUSION: Anemia was encountered in 32.9% of the elderly outpatients with CHF. Anemia was more common in the women than in the men and mild and similar in its pattern and etiology, regardless of gender. The disease prognosis was more favorable in the females than in the males.

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Клинические проявления анемического синдрома и его значение в течении хронической сердечной недостаточности у больных пожилого возраста. - Резюме. Цель исследования. Определение практической значимости анемии в течении хронической сердечной недостаточности (ХСН) у больных пожилого возраста, наблюдавшихся в поликлинических условиях. Материалы и методы. Обследовали 164 больных в возрасте от 60 до 85 лет с ХСН II-IV функционального класса (ФК) по классификации NYHA вследствие ишемической болезни сердца и артериальной гипертонии. Оценивали клинико-лабораторные и эхокардиографические показатели, регистрировали случаи госпитализации и летальные исходы. Период наблюдения составил 2,5±2,1 года. Результаты. Анемический синдром зарегистрирован у 32,9% больных (у 43,5% женщин и 26,5% мужчин; р=0,024). Выявлена связь сниженного уровня гемоглобина с нарушенной функцией почек (отношение шансов - ОШ - 2,04 при 95% доверительном интервале от 1,05 до 3,98; р=0,036). У всех больных независимо от пола анемия была легкой степени тяжести и не отличалась по характеру и этиологии. В связи с декомпенсацией ХСН госпитализированы 46,3% больных с анемией и 22,7% без анемии (р=0,002). Выживаемость больных пожилого возраста с ХСН с анемией и без анемии была одинаковой (р=0,549), однако при сравнении только больных с анемией наблюдалось различие по выживаемости между мужчинами и женщинами (р=0,005). Предикторами неблагоприятного исхода у пожилых больных с ХСН и анемией были ФК III-IV (ОШ 4,37), ХБП (ОШ 2,27) и фракция выброса левого желудочка <35% (ОШ 2,74). Заключение. В поликлинических условиях анемия встречалась у 32,9% больных пожилого возраста с ХСН. Анемия чаще выявлялась у женщин, чем у мужчин, и независимо от пола была легкого течения и не отличалась по характеру и этиологии. Прогноз заболевания у женщин был более благоприятный, чем у мужчин.
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V N Larina

Email: larinav@mail.ru

B Ia Bart

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