The following is a summary of “Insights on prevalence and incidence of anemia and rapid up-titration of oral heart failure treatment from the STRONG-HF study,” published in the September 2024 issue of Cardiology by Čelutkienė et al.

Researchers conducted a retrospective study to examine the prevalence and impact of anemia on heart failure (HF) outcomes and treatment effectiveness.

They randomized patients within 2 days before anticipated hospital discharge after worsening HF in a 1:1 ratio to high-intensity care (HIC) or usual care (UC). Baseline characteristics, clinical and safety outcomes, and the effects of HIC vs. UC on primary and secondary outcomes were compared across groups with different baseline anemia. Changes in hemoglobin during follow-up and predictors of incident anemia at 90 days were also examined.

The results showed that anemia affected 27.2% of 1,077 patients with STRONG-HF, increasing to 32.1% at 90 days. The primary composite outcome was observed in 18.2% of patients without baseline anemia and 22.5% of those with baseline anemia (unadjusted HR 1.27; 95% CI 0.90–1.80), a statistically insignificant difference. However, patients with baseline anemia showed a significantly smaller improvement in EQ-VAS scores from baseline to day 90 (adjusted LS-Mean difference −2.34 (−4.37, −0.31), P=0.02). Anemia developed in 19.4% of the HIC group and 14.6% of the UC group, resolving in 27.6% and 28.8%, respectively (P =0.1379). Predictors of anemia included male sex, non-European region, ischemic etiology, higher glucose, and elevated uric acid—no differences in optimal medication doses between patients with anemic and nonanemic. The high-intensity care strategy did not increase anemia and reduced endpoint rates, regardless of baseline hemoglobin.

Investigators found that anemia was common in patients with HF after discharge and can affect the QoL, but intensive HF treatment was safe and effective regardless of anemia status.

Source: link.springer.com/article/10.1007/s00392-024-02518-y