Prevalence of anemia in adult heart failure patients at Saint Paul’s hospital millennium medical college and Saint Peter’s speialized hospital in Addis Ababa Ethiopia: a cross sectional study

Abstract

Anemia is a frequently encountered comorbid illness in heart failure (HF) and is associated with high morbidity and mortality. Anemia is hemoglobin (Hgb) with cut off points of < 13 g/dl for men and < 12 g/dl women. It’s increased risk of hospital admissions and mortality in nearly 46.8% of patients in comparison to 29.5% in non-anemic patients but studies in Ethiopia are scarce. To assess the prevalence of anemia among adult heart failure patients in SPHMMC and St. Peter Specialized Hospital in Ethiopia. Hospital based cross-sectional study was conducted from, July 30, 2024 to November 30, 2024 among HF patients. Data was collected using a pretested semi-structured questionnaire. All covariates that have p value < = 0.2 in bivariate analysis was analyzed for further by multivariable logistic regression to detect independent predictors. From the respondent HF patients, 119 (31.8%) patients had anemia. The mean hemoglobin in the anemic group was 10 ± 0.1 g/dl as compared to 15 ± 0.5 g/dl in the non-anemic group. The odds of having anemia among HF patients with primary education was 3.3 times higher than those with collage graduate (AOR = 3.3, 95% CI 1.56–6.85, P = 0.002). The most common etiology of HF was Chronic Rheumatic Valvular Heart Disease (CRVHD) followed by dilated cardiomyopathy. Anemia was 2.6 times more common in diabetic patients with HF when compared to non-diabetics patients (AOR = 2.6, 95% CI, 1.3–5.2, P = 0.007). Patients with heart failure with preserved ejection fraction (HFpEF) had 2.2-fold higher odds of anemia compared to those with reduced ejection fraction (HFrEF) (AOR=2.2, 95% CI, 1.09-4.64 P=0.04,). Anemia is common in HF patients in our setup. Particularly in patients with lower Estimated Glomerular Filtration (eGFR), Atrial Fibrillation (AFIB), Dilated Cardiomyopathy (DCMP), Chronic Rheumatic Valvular Heart Disease (CRVHD) and Low educational status were strong predictors of anemia in HF patients. But there was no significant association between age, sex, marital status, dietary habit, New York Heart Association (NYHA) class, duration of illness, presence of Hypertension (HTN), alcohol, smoking, use of angiotensin converting enzyme inhibitors /angiotensin receptor blockers (ACEI /ARBs), Antiplatelet and Anticoagulant patients in this study.