title: Prognostic value of plasma erythropoietin on mortality in patients with chronic heart failure.
abstract: OBJECTIVE
  This study aimed to investigate the prognostic importance of plasma erythropoietin (EPO) levels in chronic heart failure (CHF) patients.
  
  
  BACKGROUND
  Anemia is common and is associated with an impaired survival in patients with CHF. Erythropoietin is a hematopoietic growth factor, upregulated in anemic conditions. Little is known about the pathophysiology of anemia in CHF and the prognostic importance of plasma EPO levels in CHF patients.
  
  
  METHODS
  In 74 patients with CHF (age, 61 +/- 2 years; left ventricular ejection fraction, 0.31 +/- 0.01; peak oxygen consumption, 19.1 +/- 0.6 [mean +/- SEM]) and in 15 control patients, hemoglobin levels and plasma concentrations of EPO and brain natriuretic peptide were measured.
  
  
  RESULTS
  During a mean follow-up of 3.0 years (range, 2.3 to 5.3 years), 22 patients (30%) died. Anemia was present in 24% of the patients. Multivariate analysis showed that plasma EPO (p = 0.026) and hemoglobin levels (p = 0.005) were independent predictors of survival in this CHF population. We observed only a mild inverse correlation between the logarithm of EPO and hemoglobin levels (r2 = 0.08, p = 0.02) in CHF patients, whereas the control group showed a clear significant inverse correlation (r2 = 0.44, p = 0.007).
  
  
  CONCLUSIONS
  Elevated plasma EPO levels are associated with an impaired prognosis independent of hemoglobin levels and other established markers of CHF severity. Furthermore, in the CHF patients, EPO levels poorly correlate with the hemoglobin levels, in contrast with the control group.
authors.affiliation: Department of Cardiology, University Hospital Groningen, Groningen, The Netherlands. p.van.der.meer@thorax.azg.nl
authors.forename: Peter
authors.initials: P
authors.lastname: van der Meer
authors.forename: Adriaan A
authors.initials: AA
authors.lastname: Voors
authors.forename: Erik
authors.initials: E
authors.lastname: Lipsic
authors.forename: Tom D J
authors.initials: TD
authors.lastname: Smilde
authors.forename: Wiek H
authors.initials: WH
authors.lastname: van Gilst
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: van Veldhuisen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D004921:Erythropoietin / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000401:mortality*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D009426:Netherlands; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013223:Statistics as Topic; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D004921:Erythropoietin; D020097:Natriuretic Peptide, Brain