Prevalence of Anemia and associated factors in Heart failure with reduced ejection fraction patients attending Tikur Anbessa specialized Hospital Cardiac Clinic from June 1- October 30

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Date

2020-12

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Addis Abeba University

Abstract

Background: Anemia is one of the common comorbidities in heart failure patients with reduced ejection fraction and its presence is associated with decreased functional capacity, poor quality of life, an increase in the rate of hospital admission, and increased mortality. Previous studies have estimated the prevalence of anemia in heart failure patients to be 10-50%. Older age, renal dysfunction, female sex, and advanced NYHA functional class are reported to be independently associated with anemia. Anemia is a prevalent problem in the Ethiopian setting affecting 23% of reproductive-age women, and 18% of adult men. But data is lacking about its prevalence and factors associated with it in heart failure patients with reduced ejection fraction in our set up. Objective: To assess the prevalence of anemia and associated factors in heart failure patients with reduced ejection fraction on follow-up in the cardiac clinic of TASH with a clinical diagnosis of HFrEF from June 1 –October 30. Method- A hospital-based prospective cross-sectional study was conducted by interviewing HFrEF patients who came to the cardiac clinic during the study period and reviewing their i-care records. CBC and renal function tests were done for these patients and the results were collected. History of diabetes, etiology of HF, use of ACEI/ARB and admission in the past 6 month was assessed from the patient’s i-care records and patient interviewing. Quality of life assessment was done using Amharic version of KCCQ-12 questioner. EF was taken from previous echo reports documented on icare records. Patient’s demographic data, laboratory parameters and KCCQ-12 score were collected using a structured checklist. The data collected was cleared, entered and analyzed using SPSS software version 20. The research was conducted with an estimated total budget of 27,148.00 birr. Result- Among 138 HFrEF patients 27(19.8%) patients had anemia. Anemic patients had a lower quality of life as indicated by lower KCCQ-12 score (34 vs 43) (p=0.004), a higher rate of admission history within 6 months prior to presentation. (44% vs 12.6%) (p=0.041) and lower mean eCrCl(75 vs 87ml/min)(P=0.046). On binomial logistic regression, male sex is also found to be an independent predictor of anemia in this study(p=0.002) but no strong association was found with the age of patients, the presence of diabetes, etiology of HF, and the use of ACEI/ARBs. Anemic patients also tend to have more NHYA class III HF than Class II HF.

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Keywords

Anemia, heart failure with reduced ejection fraction, KCCQ-12 score

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