Effect of correction of anemia with erythropoietin and intravenous iron in resistant heart failure in octogenarians.
BACKGROUND
Congestive heart failure is extremely common in octogenarians and is associated with severe fatigue, shortness of breath, recurrent hospitalizations, and death. These patients, many of whom are anemic, are often resistant to standard CHF therapy including angiotensin-converting enzyme inhibitors, beta-blockers and diuretics.


OBJECTIVE
To examine whether correction of the anemia (hemoglobin < 12 g/dl) in CHF patients can improve their clinical condition.


METHODS
Forty octogenarians with anemia and severe resistant CHF were administered a combination of subcutaneous erythropoietin and intravenous iron sucrose.


RESULTS
This combination therapy led to a marked improvement in cardiac function, shortness of breath and fatigue, a marked reduction in the rate of hospitalization and a stabilizing of renal function.


CONCLUSIONS
Anemia appears to be an important but ignored contributor to the progression of CHF, and its correction may improve cardiac and renal status as well as the quality of life in elderly patients.
Silverberg
Donald S
DS
Department of Nephrology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. donald@netvision.net.il
Wexler
Dov
D
Blum
Miriam
M
Schwartz
Doron
D
Keren
Gad
G
Sheps
David
D
Iaina
Adrian
A
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D004921:Erythropoietin / Q000008:administration & dosage* / Q000627:therapeutic use*; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use*; D000077605:Ferric Oxide, Saccharated; D005919:Glomerular Filtration Rate / Q000187:drug effects / Q000502:physiology; D005937:Glucaric Acid; D006333:Heart Failure / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D051437:Renal Insufficiency / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D012720:Severity of Illness Index; D013997:Time Factors
D005290:Ferric Compounds; D004921:Erythropoietin; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid