Prevalence of anemia in ambulatory coronary heart disease and heart failure populations of a tertiary cardiac care center of North India: Implications for clinical management

Abstract: BACKGROUND: Anaemia may aggravate symptoms and even masquerade as coronary heart disease (CHD). Correction of anaemia leads to improvement in the quality of life. Cardiologists should be aware of the problem of anaemia, its pathogenesis and the systematic workup of anaemia in CHD and heart failure (HF) populations. AIMS AND OBJECTIVES: To study the prevalence, severity, and causes of anaemia in ambulatory coronary heart disease and heart failure populations. MATERIALS AND METHODS: In this single centre, retrospective observational study, we reviewed 26,600 consecutive electronic prescriptions generated in an adult cardiology outpatient service between September 2017 and August 2024. The prescriptions were assessed for the primary diagnosis, presence and severity of anaemia, and iron and vitamin B12 deficiency. RESULTS: Anaemia was recorded in 1,600/26,600 (6.01%) prescriptions in unselected population, 1,100/14,600 (7.53%) prescriptions in CHD population, 20/488 (4.09%) in dilated cardiomyopathy (DCMP) and 104/272 (38.2%) in heart failure population. Majority of CHD and HF patients had mild anaemia 49.9% and 47.1% respectively. Severe anaemia was found in 2.0% and 1.92% in of CHD and HF patients respectively. Iron Deficiency was found in 921/1600 (57.5%), 877/1100 (79.7%) and 32/104 (30.7%) in unselected, CHD and HF patients respectively. Vitamin B12 deficiency was found in 236/1600 (14.7%), 458/1100 (41.6%) and 23/104 (22.1%) in unselected CHD and HF patients respectively. Several patients had concomitant iron and B12 deficiency. CONCLUSION: Anaemia in CHD and HF population is multifactorial. Routine screening for anaemia and workup for iron and B12 deficiency should be done in suitable cases. Iron deficiency may have varied consequences, anaemia being one of them.