Abstract: Introduction: The presence of anemia leads to a worse prognosis in patients with heart failure (HF). There are few data on the impact of anemia on mortality in pa -tients with acute heart failure (AHF), and the studies available are mainly retrospec-tive, and include hospitalised patients.Objective: Evaluate the role of anemia on 30-day and 1-year mortality in patients with AHF attended in hospital emergency departments (HEDs).Methods: We performed a multicentre, observational study of prospective cohorts of patients with AHF. The study variables were: Anemia (haemoglobin < 12g/dL in women and <13g/dL in men), mortality at 30 days and at 1 year, risk factors, co-morbidity, functional impairment, basal functional grade for dyspnoea, chronic and acute treatment, clinical and analytical data of the episode, and patient destination. Statistical analysis: Bivariate analysis and survival analyses using Cox regression.Results: A total of 13 454 patients were included, 7662 (56.9%) of whom had anemia. Those with anemia were older, had more comorbidity, a worse functional status and New York Heart Association class, greater renal function impairment, and more hy -ponatraemia. The mortality was higher in patients with anemia at 30 days and 1 year: 7.5% vs 10.7% (P< .001) and 21.2% vs 31.4% (P< .001), respectively. The crude and adjusted hazard ratios of anemia for 30-day mortality were: 1.46 (confidence interval [CI] 95% 1.30-1.64); P< .001 and 1.20 (CI 95% 1.05-1.38); P= .009, respectively,and 1.57 (CI 95% 1.47-1.68) and 1.30 (CI 95% 1.20-1.40) for mortality at 1 year. The weight of anemia on mortality was different in each follow-up period.Conclusions: Anemia is an independent predictor of mortality at 30 days and 1 year in patients with AHF attended in HEDs. It is important to study the aetiology of AHF since adequate treatment would reduce mortality.

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