Authors: Faramarz Tehrani Pavittarpaul Dhesi Daniel Daneshvar Anita Phan Asim Rafique Robert J Siegel Bojan Cercek
Publish Date: 2009/10/28
Volume: 23, Issue: 6, Pages: 511-
Abstract
Anemia is prevalent in patients with heart failure and an independent prognostic sign of poor outcome The current report is a metaanalysis of published clinical trials assessing the use of erythropoeisis stimulating agents ESA in heart failure HF patients with anemiaSeven prospective controlled trials met inclusion criteria n = 663 subjects The ESA studied was darbepoetin in 4 trials and erythropoietin in 3 trials Mean follow up period ranged from 12 to 27 weeks Compared to placebo ESA therapy was associated with improvement in six cardiovascular parameters assessed by at least three of the analyzed trials including increase in hemoglobin levels 23595 confidence interval Cl 176–293 P 000001 increase in exercise duration 09195 Cl 008–173 P = 003 improvement in New York Heart Association functional class −14695 Cl −232 to −060 P = 00009 improvement in 6minute walk test 14295 Cl 031–254 P = 001 decrease in Btype natriuretic peptide −05495 Cl −103 to −006 P = 003 and improvement in peak oxygen consumption 09395 Cl 052–134 P 000001In patients with heart failure and anemia erythropoiesis stimulating agent therapy appears to have a positive effect on several important cardiovascular parameters compared to control therapy Large prospective randomized controlled trials are warranted to comprehensively evaluate the potential effects of erythropoiesis stimulating agents on clinical outcomes in heart failure patients with anemia
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