Anemia prevalence is 56.4% in heart failure patients, linked to worse clinical profiles.

This retrospective cohort study analyzed 2,144 adult patients with heart failure (HF) from National Guard Health Affairs hospitals in Saudi Arabia. It examined anemia status and severity (categorized as mild, moderate, or severe based on hemoglobin levels) compared to non-anemic patients, with primary outcomes including prevalence and severity of anemia and the association between hemoglobin levels and B-type natriuretic peptide (BNP). Secondary outcomes covered independent predictors of anemia, clinical characteristics, laboratory parameters, and outcomes such as cardiovascular mortality, though follow-up duration was not reported.

Main results showed anemia prevalence was 56.4% (95% CI 54.3% to 58.5%), with moderate anemia most common at 53.2% of anemic cases. Increasing anemia severity was associated with older age, longer HF duration, higher prevalence of chronic kidney disease (CKD) and atrial fibrillation, worsening renal function, hypoalbuminemia, and progressively higher BNP and troponin levels, with all associations statistically significant (p < 0.05). However, absolute numbers and effect sizes for these associations were not reported, and outcomes like cardiovascular mortality lacked specific data.

Safety and tolerability data, including adverse events, serious adverse events, and discontinuations, were not reported. Key limitations include that contemporary real-world data describing the burden and relationship with biomarkers of HF severity remain limited, and the study design is observational, preventing causal inferences. Funding or conflicts of interest were not reported. In practice, these findings support routine anemia assessment in comprehensive HF care due to its high prevalence and links to disease severity, but clinicians should interpret the associations cautiously, as they do not confirm causation or directly address clinical outcomes.