Effects of treatment with epoetin beta on outcomes in patients with anaemia and chronic heart failure.
Anaemia is frequently found in patients with chronic heart failure (CHF) and has been associated with an increase in mortality and morbidity, impaired cardiac and renal function and a reduced quality of life (QoL) compared with non-anaemic CHF patients. Correction of anaemia with recombinant human erythropoietin (epoetin) has been associated with an improvement in CHF in both controlled and uncontrolled studies. The present study describes our findings in a series of 78 consecutive patients with symptomatic CHF and anaemia (haemoglobin (Hb) level <12.0 g/dl) treated with epoetin beta and, if necessary, intravenous iron sucrose. Over a mean observation period of 20.7 +/- 12.1 months, mean Hb levels increased from 10.2 +/- 1.1 to 13.5 +/- 1.2 g/dl, p < 0.01. New York Heart Association (NYHA) functional class, left ventricular ejection fraction (LVEF) were significantly improved and the number of hospitalizations was significantly reduced with the period before treatment (all p < 0.01). Serum creatinine and creatinine clearance (CCr) were 2.2 +/- 0.9 mg/dl and 32.5 +/- 26.5 ml/min, respectively, at baseline, and remained stable over the observation period. Interestingly, >90% of the patients had concomitant mild-to-moderate chronic kidney disease at baseline and study end (CKD), as defined by the accepted diagnostic criterion of a CCr <60 ml/min.


CONCLUSIONS
The correction of the anaemia with epoetin beta together with initial intravenous iron supplementation, resulted in significant improvements in NYHA class and cardiac function, and a reduction in hospitalization rate. Moreover, renal function was maintained stable in most patients.
Department of Nephrology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. donald@netvision.net.il
Donald S
DS
Silverberg
Dov
D
Wexler
Miriam
M
Blum
Adrian
A
Iaina
David
D
Sheps
Gad
G
Keren
Armin
A
Scherhag
Doron
D
Schwartz
D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D016022:Case-Control Studies; D002908:Chronic Disease; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000401:mortality; D008297:Male; D011994:Recombinant Proteins
D011994:Recombinant Proteins; C103998:epoetin beta; D004921:Erythropoietin