Erythropoiesis-stimulating agent therapy did not significantly reduce all-cause mortality (OR 0.78) but decreased hospitalizations (OR 0.61) in heart failure patients with anemia.
Meta-Analysis (n=3,044)
Does ESA therapy reduce mortality or hospitalization and improve symptoms in patients with heart failure and anemia?
ESA therapy in anemic heart failure patients improves symptoms, LVEF, and reduces hospitalizations, but does not significantly reduce all-cause mortality.
Effect estimate: OR 0.78 (95% CI 0.51-1.21)
Absolute Event Rate: 26.4% vs 27.7%
p-value: p=0.27
INTRODUCTION: Heart failure (HF) is always complicated with anemia and is associated with bad prognosis in this patient population. Several studies have assessed the potential role of erythropoietin-stimulating agent (ESA) in improving cardiac function and reducing the number of hospitalizations in anemic patients with HF. AIM: We performed a meta-analysis to assess the potential role of ESA in the treatment of anemic patients with HF. MATERIAL AND METHODS: A literature and Medline search was performed to identify studies with control groups that examined the efficacy of ESA therapy in patients with HF and anemia. RESULTS: A total of 11 studies were included (n = 3044 subjects) in the final analysis. Compared to placebo, ESA therapy was associated with increased hemoglobin levels (1.89 g/dl; 95% CI: 1.64-2.14, p < 0.00001), increased left ventricular ejection fraction (LVEF) to 6.88 (95% CI: 0.49-13.28, p = 0.03), decreased B-type natriuretic protein (-272.20; 95% CI: (-444.52)-(-99.89), p = 0.002), improvement in New York Heart Association functional class to -0.33 mean difference (95% CI: (-0.44)-(-0.23), p < 0.00001), and decreased hospitalization (OR = 0.61, 95% CI: 0.39-0.94, p = 0.02). There was no significant between-group difference in all-cause mortality (OR = 0.78, 95% CI: 0.51-1.21, p = 0.27). CONCLUSIONS: The treatment of anemia with ESA therapy did not reduce the rate of all-cause mortality among patients with heart failure, but ESA therapy made a potential important contribution to patients' symptomatic improvement.
Zhang et al. (Fri,) conducted a meta-analysis in Heart failure with anemia (n=3,044). Erythropoiesis-stimulating agents (ESA) vs. Placebo or control was evaluated on All-cause mortality (OR 0.78, 95% CI 0.51-1.21, p=0.27). Erythropoiesis-stimulating agent therapy did not significantly reduce all-cause mortality (OR 0.78) but decreased hospitalizations (OR 0.61) in heart failure patients with anemia.