Are erythropoietin stimulating proteins safe and efficacious in heart failure? Why we need an adequately powered randomised outcome trial

Veldhuisen, Dirk J. van; McMurray, John J.V.

doi:10.1016/j.ejheart.2007.01.004

Cited by 73 publications

(56 citation statements)

References 17 publications

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“…Although some studies using ESAs performed in single center trials showed improvement of NYHA functional class and echocardiographic data in CHF patients with anemia, 6,7) the latest multicenter randomized, double blind, placebo-controlled trial did not yield the expected results. 8,9) These findings might demonstrate that ESAs alone would be insufficient for improving the oxygenation of heart failure patients with anemia.…”

Section: Discussionmentioning

confidence: 99%

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Adaptive Servo-Ventilation Therapy Improves Long-Term Prognosis in Heart Failure Patients With Anemia and Sleep-Disordered Breathing

et al. 2014

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SummarySleep disordered breathing (SDB) and anemia influences the progression of chronic heart failure (CHF). Adaptive servo-ventilation (ASV) is an effective therapeutic device for treatment of CHF, however, the impacts of ASV on CHF patients with or without anemia remain unclear.A total of 139 patients with CHF and SDB were divided into two groups: those treated with ASV (n = 53) and without ASV (n = 86). All patients were prospectively followed after discharge with the endpoints of cardiac death or progressive heart failure requiring rehospitalization. There were 65 patients (47%) with anemia among all subjects. The apnea hypopnea index was improved, and plasma BNP and high sensitive C-reactive protein levels were decreased in both groups with and without anemia by ASV therapy. The Kaplan-Meier survival curve demonstrated that the cardiac event-free rate in patients with ASV was significantly higher than in those without ASV in the anemia group (P = 0.008). However, in the non-anemia group, the cardiac event-free rate was similarly high in patients both with and without ASV (P = 0.664). Multivariate Cox proportional hazard analysis demonstrated that ASV use was an independent predictor of cardiac events in the anemia group (P = 0.0308), but not in the non-anemia group.ASV treatment for CHF and SDB has more favorable impacts in patients with anemia than in those without anemia. (Int Heart J 2014; 55: 342-349)

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Section: Discussionmentioning

confidence: 99%

“…Although several reports demonstrated the benefit of ESAs in CHF patients who had declining NYHA functional classes or increasing contractions of the left ventricle, 6,7) a few reports did not reveal any definite clinical benefit of ESAs in CHF patients. 8,9) Hence, effective pharmacotherapy for CHF with anemia is still unclear.…”

mentioning

confidence: 99%

Adaptive Servo-Ventilation Therapy Improves Long-Term Prognosis in Heart Failure Patients With Anemia and Sleep-Disordered Breathing

et al. 2014

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“…Finally, ESPs are rarely used alone and, usually, concomitant iron therapy is given; the benefits and risks of iron in patients with CHF are also unquantified [32]. Consequently, the net effect (reflecting the sum of potentially beneficial and potentially harmful actions) of treatment regimens using erythropoietin (or other synthetic ESPs) is difficult to predict and needs to be determined in appropriated designed, powered, conducted and analyzed clinical trials [33].…”

Section: Effects Of Exogenous Erythropoietinmentioning

confidence: 99%

“…Darbepoetin, is currently being tested in a large-scale, phase III morbidity and mortality trial, the Reduction of Events with Darbepoetin alfa in Heart Failure (RED-HF) which complements the existing outcome trials with ESAs conducted in patients with chronic kidney disease and which will contribute important information of the safety and efficacy of ESAs (Table 2) [33].…”

Section: Darbepoetin Alfa As a Treatment For Chfmentioning

confidence: 99%

Approaches to the treatment of anaemia in patients with chronic heart failure

Murphy

McMurray

2008

Heart Fail Rev

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“…[71]) with darbapoetin-α versus placebo on 475 patients not show a statistically significant improvement of NYHA class and Quality of Life. Despite small sample size, it is observed a trend in decreasing the risk of composite outcome (death or HF hospitalization) and mortality rate in darbapoetin-α group versus placebo group (39 of 266, 15% vs 46 of 209, 22%; HR 0.67, 95% CI 0.44-1.03, p=0.06) and a trend to a less mortality in the darbapoetin-α treated patients (6% vs 9%; HR, 0.76).…”

Section: Studies With Darbapoetin-αmentioning

confidence: 99%

Anaemia and heart failure

et al. 2010

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AbstractAnaemia is one of the most frequent co-morbidities in patients with heart failure. Its prevalence increases from 4% to7% in subjects with asymptomatic left ventricular dysfunction to >30% in patients with severe heart failure. Renal insufficiency, activation of inflammatory mediators and treatment with renin-angiotensin antagonists seem to be its main determinants. The results of many studies agree in providing evidence that anaemia is a powerful independent determinant of survival in patients with heart failure. However, the mechanisms of this relation are still not fully understood. Moreover a favourable effect of the correction of anaemia on prognosis has not yet been shown. Also In addition to this, controlled studies assessing its effects on exercise tolerance have yielded controversial results. Further research is needed to assess the effect of correcting anaemia in chronic heart failure (CHF) patients; ongoing reduction of events with RED-HF (Darbepoetin alpha in heart failure) trial will help define the role.

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Are erythropoietin stimulating proteins safe and efficacious in heart failure? Why we need an adequately powered randomised outcome trial

Cited by 73 publications

References 17 publications

Adaptive Servo-Ventilation Therapy Improves Long-Term Prognosis in Heart Failure Patients With Anemia and Sleep-Disordered Breathing

Adaptive Servo-Ventilation Therapy Improves Long-Term Prognosis in Heart Failure Patients With Anemia and Sleep-Disordered Breathing

Approaches to the treatment of anaemia in patients with chronic heart failure

Anaemia and heart failure

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