Prevalence of Anemia in Heart Failure Patients Hospitalized in a Cardiology Department in Dakar, Senegal

The objectives of this study were to assess the prevalence of anemia in patients with heart failure, analyze the characteristics of anemia in this population, and identify prognostic factors related to anemia and heart failure. We conducted a descriptive and analytical retrospective study over a period of nine months, from April 1, 2018, to December 31, 2018. The study included patients aged over 18 years who were hospitalized in a cardiology department for heart failure of all causes, with hemoglobin levels strictly below 12 g/dl for women and 13 g/dl for men. Heart failure diagnosis was based on ESC 2016 criteria. The study was approved by the ethics committee of Cheikh Anta Diop University, Dakar. Data analysis was performed using SPSS 18 (Statistical Package for Social Sciences version 18), with a p-value of ≤ 0.05 considered statistically significant. We identified 182 patients with anemia, representing a hospital prevalence of 11.61%. The average age was 58.9 ± 15.93 years, with a female predominance in those under 50 years and a male predominance in those over 50. Most patients (77.1%) had a low socioeconomic status. Major cardiovascular risk factors included physical inactivity (56%) and hypertension (47%). Clinically, 78% of patients had dyspnea, 31.9% had chest pain, 40.7% had cutaneous-mucosal pallor, and 72.2% had global heart failure. Ischemic heart disease was the main cause of heart failure (49.2%). Diagnostic investigations revealed elevated ferritin in 50% of cases, elevated CRP in 88.1%, and elevated creatinine in 37.4%. The mean hemoglobin level was 11.6 ± 7.15 g/dl, with 71.4% of patients having hemoglobin between 10 and 13 g/dl. Normocytic normochromic anemia predominated. The study showed that anemia was more common in patients with an ejection fraction > 50% (48.1%) and those with global heart failure (72.2%). Statistically significant associations with severe and mild anemia were observed in the age groups 20-29 years (p=0.003) and 50-59 years (p=0.014) and with endocarditis (p=0.03). Only women showed severe and very severe anemia (p=0.21). The hospital mortality rate was 15.38%. In conclusion, this study reveals a significant prevalence of anemia among hospitalized patients, with important correlations between anemia and various clinical and socioeconomic factors.