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Calcium antagonists, digoxin, calcaemia and anaemia in heart failure

Objective: To reveal that Calcium Antagonist (CA) use is associated with lower haemoglobin (Hb) and digoxin use is associated with higher Hb in Heart Failure (HF).

Method: 223 chronic HF patients in acute decompensation phase were included in the study. Patients with comorbidities leading to anemia and those receiving blood transfusion or antianaemic treatment were excluded. Patients were classified into two groups as anemic and non-anemic groups. Two groups were compared retrospectively with demographics, clinical findings, medication use, echocardiography findings, complete blood count and biochemistry. Different independent variables between two groups were subjected to Multivariate Binary Logistic Regression Analysis (MBLRA) under the dependent variable anemia. Multivariable linear Regression Analysis (RA) was also performed with the dependent variable of Hb.

Results: MBLRA results showed that anemia was seen less frequently in digoxin users, whereas it was more frequent in the following conditions: CA use, chronic renal failure, lower AST, lower LDL cholesterol, lower triglyceride, lower Transferring Saturation Rate (TSR). RA results also showed that lower LDL cholesterol, lower eGFR, lower transferrin saturation rate, lower corrected calcium, female gender and CA use were associated with lower Hb; whereas, digoxin use was associated with higher Hb.

Conclusions: Haemoglobin levels were found higher in digoxin users. CA use, lower corrected calcium and lower AST were associated with lower Hb in heart failure. These findings have not been reported so far.

Author(s): Sati Sena Yildiz, Didem Dikerdem, Ali Ramazan Benli, Pinar Kalem, Mehmet Ali Cikrikcioglu