Treatment with subcutaneous erythropoietin and intravenous iron in anemic patients with severe CHF reduced mean hospitalizations by 91.9% compared with a similar period before the study.
Observational (n=142)
No
Does subcutaneous erythropoietin and intravenous iron improve cardiac function, renal function, and reduce hospitalizations in patients with severe congestive heart failure and anemia?
Correction of anemia with subcutaneous erythropoietin and intravenous iron in patients with severe, resistant congestive heart failure improves cardiac and renal function and markedly reduces hospitalizations.
Effect estimate: 91.9% reduction
OBJECTIVES: This study evaluated the prevalence and severity of anemia in patients 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 supplementation in treating this anemia is unknown. METHODS: In a retrospective study, the records of the 142 patients in our CHF clinic were reviewed to find the prevalence and severity of anemia (hemoglobin 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 severe CHF and were also anemic. They were treated with subcutaneous erythropoietin and intravenous iron sufficient to increase the Hb to 12 g%. The doses of the CHF medications, except for diuretics, were not changed during the intervention period. RESULTS: The prevalence of anemia in the 142 patients increased with the severity 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 for a mean of 7.2 +/- 5.5 months. The mean Hb level and mean left ventricular ejection fraction increased significantly. The mean number of hospitalizations fell by 91.9% compared with a similar period before the study. The New 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 associated with a significant improvement in cardiac function, functional class, renal function and in a marked fall in the need for diuretics and hospitalization.
Silverberg et al. (2000) conducted an observational in Congestive heart failure and anemia (n=142). Subcutaneous erythropoietin and intravenous iron vs. Similar period before the study (pre-intervention) was evaluated on Mean number of hospitalizations (91.9% reduction). Treatment with subcutaneous erythropoietin and intravenous iron in anemic patients with severe CHF reduced mean hospitalizations by 91.9% compared with a similar period before the study.
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