Kok Leng, Tan
(2014)
A study of anemia and iron deficiency in chronic systolic heart failure.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background: Iron deficiency (ID) is an emerging problem in patients with chronic systolic heart
failure and can be a potential therapeutic target. However, not much is known about the
frequency, predictors of iron deficiency and anemia in patients with chronic heart failure.
Objectives: The primary objective of this study was to determine the frequency of iron
deficiency in chronic systolic heart failure patients who were follow up in Hospital Universiti
Sains Malaysia. The secondary objectives included were to determine the frequency of anemia in
the same study population, correlation between ejection fraction and blood parameters and
determining risk factors for anemia in chronic systolic heart failure.
Methods: A total of 81 patients who were followed up in Hospital Universiti Sains Malaysia
were recruited into this cross sectional study using purposive sampling method. These patients
had history of chronic systolic heart failure for more than 6 months with left ventricular ejection
fraction less than 45% as assessed by echocardiography using Simpson’s planimetric method.
10mls of venous blood was drawn from each participant and analyzed.
Results: Thirty three patients were anemic (40.7%) as compared to 48 patients (59.3%) who did
not. Sixteen patients were iron deficient (19.8%). All iron deficiency patients were anemic
patients. There were positive correlation between serum ferritin (r=0.624, p<0.001), transferrin
saturation (r= 0.346, p<0.001) and hemoglobin (r=0.528, p<0.001) with ejection fraction,
respectively.
Anemia in chronic systolic heart failure was independently associated with serum ferritin
(OR 0.974, 95% CI 0.959, 0.988), transferrin saturation (OR 0.831, 95% CI 0.726, 0.952), and
diabetes mellitus (OR 6.680, 95% CI 1.599, 27.897) based on multiple logistic regression
analysis.
Conclusion: This study demonstrated high frequency of anemia in chronic systolic heart failure
patients. Majority of anemic patients were iron deficient. Besides that, serum hemoglobin and
serum ferritin and transferrin saturation were positively correlated with left ventricular ejection
fraction. It is recommended in future, an appropriately powered randomized trials with correction
of anemia using erythropoietin and intravenous iron be carried out to validate the study findings.
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