The use of subcutaneous erythropoietin and intravenous iron for the treatment of the anemia of severe, resistant congestive heart failure improves cardiac and renal function and functional cardiac class, and markedly reduceshospitalizations
Ds. Silverberg et al., The use of subcutaneous erythropoietin and intravenous iron for the treatment of the anemia of severe, resistant congestive heart failure improves cardiac and renal function and functional cardiac class, and markedly reduceshospitalizations, J AM COL C, 35(7), 2000, pp. 1737-1744
Citations number
61
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
OBJECTIVES This study evaluated the prevalence and severity of anemia in pa
tients with congestive heart failure (CHF) and the effect of its correction
on cardiac and renal function and hospitalization.
BACKGROUND The prevalence and significance of mild anemia in patients with
CHF is uncertain, and the role of erythropoietin with intravenous iron supp
lementation in treating this anemia is unknown.
METHODS In a retrospective study, the records of the 142 patients in our CH
F clinic were reviewed to find the prevalence and severity of anemia (hemog
lobin [Hb] <12 g). In an intervention study, 26 of these patients, despite
maximally tolerated therapy of CHF for at least six months, still had had s
evere CHF and were also anemic. They were treated with subcutaneous erythro
poietin and intravenous iron sufficient to increase the Hb to 12 g%. The do
ses of the CHF medications, except for diuretics, were not changed during t
he intervention period.
RESULTS The prevalence of anemia in the 142 patients increased with the sev
erity of CHF, reaching 79.1% in those with New York Heart Association class
IV. In the intervention study, the anemia of the 26 patients was treated f
or a mean of 7.2 +/- 5.5 months. The mean Hb level and mean left ventricula
r ejection fraction increased significantly. The mean number of hospitaliza
tions fell by 91.9% compared with a similar period before the study. The Ne
w York Heart Association class fell significantly, as did the doses of oral
and intravenous furosemide. The rate of fall of the glomerular filtration
rate slowed with the treatment.
CONCLUSIONS Anemia is very common in CHF and its successful treatment is as
sociated with a significant improvement in cardiac function, functional cla
ss, renal function and in a marked fall in the need for diuretics and hospi
talization. (J Am Coll Cardiol 2000;35:1737-44) (C) 2000 by the American Co
llege of Cardiology.