Anemia in heart failure: evidence from a three-year cross-sectional study in Sudan

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BACKGROUND: Anemia is a frequent complication of heart failure (HF) that exacerbates cardiac dysfunction and worsens prognosis. However, its exact burden and treatment patterns in Sudan HF remain unknown. Thus, this study aimed to describe the prevalence, characteristics, and management of anemia among Sudanese HF patients. METHODS: We conducted a retrospective cross-sectional study of adult HF patients admitted to Wad Medani Heart Center, Sudan, over three years. Baseline hemoglobin (Hb) was defined as the first measurement within 24-48 h of index admission. Only patients with evaluable baseline Hb were included in the analytic cohort. RESULTS: Of 557 HF patients, 266 (47.8% of full cohort; 51% of analytic cohort) were anemic (mean Hb 10.68 ± 1.51 g/dL). The mean age was 60.4 ± 18 SD, 136 (51%) were females, 114 (43%) aged more than 65 years, and 77 (28%) had prior HF admissions. Hypertension 136 (51%), diabetes 91 (34%) and chronic kidney disease 75 (28%) were other comorbidities. Anemia was most prevalent in the HF with mid-range ejection fraction (HFmrEF) cohort 134 (50.4%), followed by HF with reduced ejection fraction (HFrEF) 71 (26.7%) and HF with a preserved ejection fraction (HFpEF) 61 (22.9%). Among anemic HF patients, only 77 (29%) received anemia management. Of those, 28(36.4%) received blood transfusions, and 34 (44.2%) received iron supplementation. CONCLUSIONS: Nealy half of HF patients were anemic, particularly older and those with HFmrEF, and treatment was suboptimal. Incorporating routine anemia screening and standardized management into HF care protocols is essential to enhance clinical outcomes.

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