Cardiovascular Journal of Africa: Vol 26 No 3 (May/June 2015)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 26, No 3, May/June 2015 140 AFRICA
Prevalence of anaemia among patients with heart failure
at the Brazzaville University Hospital
Méo Stéphane Ikama, Bernice Mesmer Nsitou, Innocent Kocko, Ngamami Solange Mongo, Gisèle
Kimbally-Kaky, Jean Louis Nkoua
Abstract
Background: Heart failure (HF) is a frequent cause of hospi-
talisation in cardiology. Its prognosis depends on several risk
factors, one of which is anaemia.
Objectives: We aimed to determine the prevalence of anaemia
in patients with heart failure, and evaluate its impact on their
prognosis.
Methods: This article describes a cross-sectional study with
prospective collection of data, carried out from 1 January
to 31 December 2010 in the Department of Cardiology at
Brazzaville University Hospital, Congo. Patients admitted
for heart failure were included. Anaemia was defined as a
haemoglobin level < 12 g/dl for men and < 11 g/dl for women.
Results: In total, 130 men (47.8%) and 142 women (52.2%)
were recruited, mean age 56.9 ± 16.5 years. The prevalence of
anaemia was 42%. Average levels of haemoglobin were 9.4 ±
1.8 and 13.8 ± 4.9 g/dl for the anaemic (A) and non-anaemic
(NA) patients, respectively (p = 0.0001). Two hundred and
forty-nine patients (91.5%) were in NYHA functional class
III–IV. Forty-seven patients (17.3%) were on oral anticoagula-
tion and 15 (5.5%) were on aspirin. The average duration of
hospital stay was 19.1 ± 16.7 days, without a significant differ-
ence between the A and NA groups (19.4 ± 12 vs 18.8 ± 13.8
days; p = 0.79, respectively). Total mortality rate was 17%,
with a significant difference between the A and NA groups
(26 vs 10%; p = 0.001).
Conclusion: This preliminary study showed a high prevalence
of anaemia in patients with heart failure, and it had a negative
effect on the prognosis.
Keywords: heart failure, anaemia, prevalence, prognosis, Congo
Submitted 27/7/14, accepted 3/2/15
Cardiovasc J Afr 2015; 26: 140–142
DOI: 10.5830/CVJA-2015-021
Heart failure (HF) is a frequent cause of hospitalisation in
cardiology. Its prognosis depends on several factors, including
anaemia, which is common among patients with heart failure.1
Anaemia is an independent prognostic factor for mortality in
chronic HF and is associated with higher rates of mortality,
hospitalisation and re-admission. 2,3 Anaemia is a powerful
independent predictor of death and hospitalisation in systolic
and diastolic dysfunction.2,4-7
In order to improve the management of patients suffering
from systolic and diastolic HF, it is critical to understand
the relationship between HF and anaemia, and the possible
outcomes. The aim of this study was to determine the prevalence
of anaemia in patients with heart failure and to evaluate its
impact on the prognosis of patients in Brazzaville, Congo.
Methods
This article describes a cross-sectional study with a prospective
approach to data collection, carried out from 1 January to 31
December 2010 in the Department of Cardiology and Internal
Medicine at Brazzaville University Hospital. The study included
patients admitted for left or biventricular heart failure. Patients
admitted for exclusively right heart failure, or a cause other than
heart failure, as well as for sickle anaemia, were excluded.
Anaemia was defined as a haemoglobin level < 12 g/dl for men
and < 11 g/dl for women. Two hundred and seventy-two patients
were selected and divided into two groups according to anaemic
status: anaemic (n = 114) and non-anaemic patients (n = 158).
Socio-demographics such as age, gender and socio-economic
level were analysed, as well as clinical and echocardiographic
parameters, including type of heart failure (left or biventricular),
NYHA (New York Heart Association) functional class, the use
of aspirin and/or oral anticoagulation, type of heart disease, and
left ventricular ejection fraction (LVEF). In addition, we studied
blood profiles, including haemoglobin level, renal function
(estimated by glomerular filtration rate using the Cockroft–
Gault equation; considered to be lowered if GFR < 60 ml/min).
Finally, we analysed prognosis in terms of duration of hospital
stay, and mortality rate (outcome for that same admission).
Statistical analysis
The data were analysed with Epi-info 3.5.1 software. The
chi-squared and ANOVA tests allowed the comparison of
qualitative and quantitative variables, respectively. The
significance level was p < 0.05.
Results
A total of 272 patients were evaluated, including 130 men
(47.8%) and 142 women (52.2%), with a mean age of 56.9 ± 16.5
years (range: 18–97). The prevalence of anaemia was 42%, with
an average haemoglobin level of 11.9 ± 4.4 g/dl (range: 4.7–15.2).
Cardiologie, CHU de Brazzaville, Brazzaville, Congo
Méo Stéphane Ikama, MD,
Bernice Mesmer Nsitou, MD
Ngamami Solange Mongo, MD
Gisèle Kimbally-Kaky, PhD
Jean Louis Nkoua, PhD
Hématologie clinique, CHU de Brazzaville, Brazzaville, Congo
Innocent Kocko, MD