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Anemia in Adolescents and Young Adult Patients With Congenital Heart Disease

Rodríguez-Hernández, Juan L., MD*; Rodríguez-González, Fayna, MD, PhD; Martínez-Quintana, Efrén, MD, PhD*,‡

Journal of Pediatric Hematology/Oncology: November 2018 - Volume 40 - Issue 8 - p 620–624
doi: 10.1097/MPH.0000000000001115
Clinical and Laboratory Observations

Introduction: Despite anemia in acquired heart disease being a common problem, little is known in patients with congenital heart disease (CHD).

Methods: In total, 544 consecutive stable noncyanotic CHD patients were studied to determine demographic, clinical, and analytic parameters. Anemia was defined as a condition in which hemoglobin concentration was <13 g/dL in male individuals and <12 g/dL in female individuals.

Results: In total, 49 (9%) CHD patients had anemia. Patients with complex anatomy had the highest prevalence of anemia (33%). The median hemoglobin concentration was 14.4 (13.5 to 15.6) mg/dL. Of the total anemic CHD patients, 21 of 49 (43%) were microcytic (mean corpuscular volume <84 fL) and 46 of 49 (94%) had a mean corpuscular volume under 95 fL. Oral anticoagulation, oral antiaggregation, diuretic treatment, and having valve prostheses or cardiovascular risk factors, such as arterial hypertension or diabetes mellitus, did not reach statistical significance between anemic and nonanemic CHD patients. Multivariate analyses determined as risk factors for anemia a worse New York Heart Association functional class (patients in class >II/IV) (odds ratio [OR], 8.37; 95% confidence interval [CI], 1.69-41.35), N-terminal proB-type natriuretic peptide levels >125 pg/mL (OR, 7.90; 95% CI, 2.88-21.69), and apoferritn levels below 15 ng/mL (OR, 0.21; 95% CI, 0.09-0.50). The Kaplan-Meier survival analysis showed no significant differences in mortality between anemic and nonanemic CHD patients (P=0.143).

Conclusions: The incidence of anemia in CHD patients is similar to that of the normal population and iron deficiency anemia accounts for most of the cases. There were no significant differences in mortality between CHD patients with and without anemia.

*Cardiology Service, Insular-Materno Infantil University Hospital

Ophthalmology Service, Dr. Negrín University Hospital of Gran Canaria

Department of Medical and Surgical Sciences, Faculty of Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain

The authors declare no conflict of interest.

Reprints: Efrén Martínez-Quintana, MD, PhD, Cardiology Service, Complejo Hospitalario Universitario Insular-Materno Infantil, Avd Marítima del Sur s/n, 35016 Las Palmas de Gran Canaria, Spain (e-mail:

Received May 3, 2017

Accepted November 24, 2017

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.