Abstract Ref Number = APCP212
ANEMIA AS PROGNOSTIC FACTOR OF HEART FAILURE IN CHILDREN WITH LEFT TO RIGHT SHUNT ACYANOTIC CONGENITAL HEART DISEASE
Weny Inrianto,Indah K Murni,Sri Mulatsih
Faculty of Medicine Public Health and Nursing Universitas Gadjah Mada
Background : Anemia is highly prevalent affecting morbidity and mortality in adults with acquired heart disease. However, its role in children with acyanotic congenital heart disease is unclear.
Material : We conducted a case-control study in pediatric cardiology clinic, Dr. Sardjito hospital from January to December 2017 recruiting children with left to right shunt acyanotic congenital heart disease. Case group consisted of subjects with heart failure, control group consisted of subjects without heart failure. Anemia was defined as hemoglobin concentration <11 mg/dL. Measured outcome was the incidence of congestive heart failure determined by Ross criteria. We analyzed anemia, defect type, defect size, age of diagnosed, and gender to determine factors that predicted heart failure by logistic regression analysis.
Results : We included 145 patient, of those 34.5% patient suffered from heart failure. The prevalence of anemia was 40%. Ventricle septal defect (VSD) was the most common defect observed (37.2%), followed by patent ductus arteriosus (34.5%), and atrial septal defect (28,3%). In case group, 46% subjects were suffered from anemia. Logistic regression revealed that size of defect was the most significant factor predicting heart failure with OR 8.64 (95% CI 2.63 – 28.42) for moderate shunt size and 27.97 (95% CI 8.32 – 94.0) for large shunt size. Anemia, type of defect, age of diagnosed, and gender were not statistically significant in predicting the outcome.
Conclusions : Among children with left to right shunt acyanotic congenital heart disease, moderate and large shunt sizes significantly increase risk of congestive heart failure whereas anemia, type of defect, age of diagnosed, and gender were not significant factors affecting heart failure.
Keywords: anemia heart failure congenital heart defects risk factors