Observational studyBMC medicine2025
Diagnostic work-up of anemia and associated health outcomes in people with heart failure.
Observational study in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Remnant Cholesterol Inflammatory Index for Predicting Heart Failure Risk in Patients with Coronary Artery Disease and Type 2 Diabetes: A Retrospective Study Using Multiple Machine Learning Approaches.Risk management and healthcare policy · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundAnemia is common in patients with heart failure (HF). Although iron testing is recommended, it is uncertain that solely emphasizing iron testing could result in lesser attention to other causes, like bleeding or cancer. This study aimed to evaluate the diagnostic work-up of incident anemia in patients with HF in routine care and associated health outcomes.
methodsObservational study of 8932 non-anemic adults with HF in Stockholm, Sweden, was quantified for incidence of anemia, diagnostic work-up (recognition, laboratory/invasive testing) and treatment across severity of anemia and setting of care. Time-varying Cox regression explored associations between developing anemia and rate of major adverse cardiovascular events (MACE), HF hospitalization, cancer, and death.
resultsDuring median 2.7 years, 34% of patients developed incident anemia, and 13% developed severe anemia. Within 6 months from incident anemia, ferritin and transferrin saturation were tested in 44% overall and 65% of severe cases. Testing of liver enzymes, creatinine, and C-reactive protein was, however, done in > 90% of cases. Colonoscopy, esophagogastroduodenoscopy, urinalysis, and cystoscopy were performed in 2-10% of cases. Few patients were recognized with an ICD code diagnosis of anemia (16%). Treatments were infrequent: oral iron (10%), intravenous iron (16%), blood transfusions (6%), and erythropoietin-stimulating agents (< 1%). More anemia cases received treatment in cardiology care (43%) versus primary care (29%). New-onset anemia was associated with risk of MACE (adjusted HR 2.13, 95% CI 1.85-2.44), HF hospitalization (4.85, 4.30-5.48), cancer (3.41, 3.09-3.77), and death (2.04, 1.82-2.29).
conclusionsOne in three patients with HF experienced anemia, which was associated with adverse health outcomes. Testing for iron stores and invasive work-up was suboptimal. A large proportion of anemia events remained under-recognized and untreated, a pattern of care that warrants correction.
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