Balneo and PRM Research Journal 2022, 13(3), https://doi.org/ 10.12680/balneo.2022.512 http://bioclima.ro/Journal.htm
Research article
The Impact of Antithrombotic Therapy in Patients with De-
compensated Heart Failure and Iron
Ion Alexandru Cristian
1,2
, Liviu Ionut Serbanoiu
1,2
, Stefan Sebastian Busnatu
1,2
, Valentin Chioncel
1,2
,
Catalina Liliana Andrei
1,2
1
Carol Davila University of Medicine and Pharmacy Bucharest
2
Bagdasar Arseni Emergency Hospital, Cardiology Department
* Correspondence: liviu-ionut.serbanoiu@drd.umfcd.ro
Abstract: The iron deficient anaemia is a common medical condition in patients with heart
failure receiving antithrombotic therapy. Especially during the COVID19 pandemic
period the rate of bleeding complications associated with the antithrombotic therapy tend
to be higher, as the patient’s referral to medical services is lower and the interaction
doctor-patient is limited. In our retrospective observational study we included 300
consecutive patients with decompensated heat failure associating iron deficient anaemia.
For defining the medical conditions we used the ESC guidelines terminology and
diagnostic criteria. We assessed the association between the iron deficient anaemia and
different antithrombotic therapies, recommended in concordance to ESC Guidelines. We
found that aspirin 75mg/day was statistical significant associated with iron deficient
anaemia (p 0.012) and anaemia severity (p 0.002), this association being assessed by Chi
square and Pearson tests. Also, neither clopidogrel, ticagrelor, VKA or non-VKA were
associated to the presence of anaemia. By assessing the mortality rate associated to
anaemia severity, the severe anaemia was associated to higher mortality rate, meanwhile
no antithrombotic therapy was associated with higher readmission or mortality rate
(p<0.001). In conclusion, aspirin was the only antithrombotic therapy associated with the
presence of anaemia and anaemia severity, while only severe anaemia was associated
with statistic significant increase of patient’s mortality, with nonstatistical result
regarding the readmission rate. This finding is concordant to the necessity of a permanent
evaluation of the antithrombotic therapy in heart failure patients.
Keywords: antithrombotic therapy, decompensated heart failure, iron deficient anaemia, COVID 19 pande-
mic, mortality rate
1. Introduction
Iron deficiency (ID) and anaemia are two comorbidities that are very frequently associa-
ted with heart failure (HF). These comorbidities are associated with higher readmission
and mortality rates (1,2). In the study by Iorio et al. five non-cardiovascular comorbidities
( anaemia, chronic kidney disease (CKD) , chronic obstructive pulmonary disease
(COPD) , diabetes mellitus (DM) , and peripheral artery disease(PAD)) revealed an im-
portant impact on all cause mortality (hazard ratio (HR) 1.25; 95% confidence interval
(CI) 1.10-1.26; P < 0.001), all-cause hospitalization (HR 1.17; 95% CI 1.12-1.23; P < 0.001),
HF hospitalization (HR 1.28; 95% CI 1.19-1.38; P < 0.001) (2).
Citation: Cristian I.A., Șerbanoiu
L.I., Busnatu Ș.Ș., Chinocel V., An-
drei C.L. - The Impact of Antithrom-
botic Therapy in Patients with De-
compensated Heart Failure and Iron
Balneo and PRM Research Journal
2022, 13(3): 512
Academic Editor(s):
Constantin Munteanu
Received: 01.08.2022
Accepted: 20.08.2022
Published: 01.09.2022
Reviewers:
Elena Valentina Ionescu
Mariana Rotariu
Publisher’s Note: Balneo and PRM
Research Journal stays neutral with
regard to jurisdictional claims in pub-
lished maps and institutional affilia-
tions.
Copyright: © 2022 by the authors.
Submitted for possible open access
publication under the terms and con-
ditions of the Creative Commons At-
tribution (CC BY) license (https://cre-
ativecommons.org/licenses/by/4.0/).