Anemia as a risk factor and therapeutic target in heart failure
Why the study?
Anemia is recognized as an important comorbid condition and potential therapeutic target in heart failure, but the balance of risks and benefits of its treatment remains under investigation.
Structured PICO
P
Population
Patients with heart failure
I
Intervention
Treatment of anemia
Anemia is a common comorbidity and independent risk factor in heart failure, but the balance of risks and benefits for its treatment requires further definitive data.
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Anemia in patients with heart failure is still relevant even though the therapies studied thus far have not shown positive clinical results”
DJDirk J. van VeldhuisenCardiologist, University Medical Center Groningen
“There is increasing evidence of a link between anemia and heart failure, and of the potential that treating anemia in heart failure patients may be beneficial over time”
“This is all based on a relatively small sample size. Some of these trials were small proof-of-concept trials; others were mechanistic and looked at the effects of different doses. None were individually powered for clinical events. The follow-up was relatively short, at 2-12 months.”
Implication
Anemia remains relevant in HF despite neutral therapies to date; leaves open whether novel treatments improve outcomes in dedicated trials.
Abstract
Anemia has recently been recognized as an important comorbid condition and potentially novel therapeutic target in patients with heart failure (HF). Anemia is common in HF patients, with a prevalence ranging from 4% to 55% depending on the population studied. Multiple potential mechanisms of interaction exist between anemia and the clinical syndrome of HF, including hemodilution, inflammatory activation, renal insufficiency, and malnutrition. A growing body of literature from observational databases and clinical trials suggests that anemia is an independent risk factor for adverse outcomes in patients with HF. Although preliminary data suggest that treatment of anemia may result in significant symptomatic improvement in HF, aggressive treatment of anemia may also be associated with increased risk of hypertension or thrombosis. Multiple ongoing studies will provide definitive data on the balance of risks and benefits of anemia treatment in chronic HF.
Discussion
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Cite This Study
Felker et al. (2004) studied this question.