Authors

• Ivo Darko Gabrić — Klinički bolnički centar Sestre milosrdnice, Zagreb, Hrvatska — ORCID: 0000-0003-4719-4634
• Ivana Tomašić — Klinički bolnički centar Sestre milosrdnice, Zagreb, Hrvatska — ORCID: 0000-0002-7345-5829
• Karlo Golubić — Klinički bolnički centar Sestre milosrdnice, Zagreb, Hrvatska — ORCID: 0000-0003-0684-6333
• Matias Trbušić — Klinički bolnički centar Sestre milosrdnice, Zagreb, Hrvatska — ORCID: 0000-0001-9428-454X
• Jasna Čerkez Habek — Klinička bolnica Sveti Duh, Zagreb, Hrvatska — ORCID: 0000-0003-3177-3797
• Diana Delić-Brkljačić — Klinički bolnički centar Sestre milosrdnice, Zagreb, Hrvatska — ORCID: 0000-0002-7116-2360

Abstract

**Zaključak:** Anemija u bolesnika s KZS predstavlja značajni faktor loše prognoze te može uzrokovati učestalije hospitalizacije i preglede u hitnoj ambulanti. Kako liječenje čak i visokim dozama peroralnog željeza kod tih bolesnika nije dovelo do kliničkog poboljšanja uveden je novi protokol dokazano korisnog liječenja tih bolesnika visokodoznim intravenskim željezom. **Introduction:** Anemia is frequent in patients with chronic heart failure (CHF) and is connected to a worse prognosis, regardless the severity and type. The correction of anemia contributes to the improvement of health, which also reduces the number of hospitalizations, improves the survival rate and the quality of life. (1-3) **Patients and Methods:** This retrospective analysis includes patients with CHF and a reduced systolic function of the left ventricle who have been treated for the last three years at the Department of Cardiology University Hospital Centre “Sestre milosrdnice“ in Zagreb. The method of parallel sample was used to compare the data of a hundred patients with anemia and a hundred patients without anemia. Using the statistical analysis of multiple factors it was attempted to determine the influence of anemia as an independent risk factor in the number of repeated hospitalizations. **Results:** Although patients with anemia were older than those without anemia (median 77 (66-85): 67.5 (58-75.3); p <0.0001, Mann-Whitney), it was determined that patients with CHF and anemia were hospitalized more frequently than those who have CHF without anemia (median 4 (3-6):2 (1-4); p <0.0001, Mann-Whitney). Patients with anemia were more often examined in the unified urgent reception (median (4 (3-6): 2 (1-4); p <0.0001, Mann-Whitney). **Conclusion**: Anemia in patients with CHF represents a significant factor of a bad prognosis and can cause more frequent hospitalizations and examinations in the emergency department. Even treating these patients with high doses of oral iron hasn’t led to a clinical improvement, so a new protocol was introduced with a proven and beneficial treatment of these patients with high dose intravenous iron.

Keywords

anemia, iron deficiency, heart failure, hospitalization

DOI

Literature

1. Ezekowitz JA, Mc Alister FA, Amstrong PW. Anemia Is Common in Heart Failure and Is Associated With Poor Outcomes Insights From a Cohort of 12 065 Patients With New-Onset Heart Failure. Circulation. 2003 Jan 21;107(2):223–5. https://doi.org/10.1161/01.CIR.0000052622.51963.FC
2. Lewis GD, Malhotra R, Hernandez AF, McNulty SE, Smith A, Felker GM, et al. NHLBI Heart Failure Clinical Research Network. Effect of Oral Iron Repletion on Exercise Capacity in Patients With Heart Failure With Reduced Ejection Fraction and Iron Deficiency: The IRONOUT HF. JAMA. 2017 May 16;317(19):1958–66. https://doi.org/10.1001/jama.2017.5427
3. Anker SD, Kirwan BA, van Veldhuisen DJ, Filippatos G, Comin-Colet J, Ruschitzka F, et al. Effects of ferric carboxymaltose on hospitalisations and mortality rates in iron-deficient heart failure pts. Eur J Heart Fail. 2018 Jan;20(1):125–33. https://doi.org/10.1002/ejhf.823