Anemia and chronic heart failure: from pathophysiologic mechanisms to clinical trial designs.
In patients with heart failure, anemia is highly prevalent and associated with impaired outcomes. These clinical observations necessitate the realization of pharmacologic interventions to mitigate the effects of anemia and a number of available agents are being tested in large, randomized clinical trials. However, from the pathophysiologic point of view, anemia is multifactorial and difficult to attribute to a single mechanism. Moreover, classic indicators for the identification of etiology and pathways have been found to be less accurate than expected. For these reasons future clinical trials must be designed to be able to elucidate the complexity of mechanisms and the implications for treatment strategies.
Macchia
Alejandro
A
Fundación GESICA (Clinical Investigation Study Group in Argentina), Avenida Rivadavia 2358, 1 piso oficina 4 (C1034ACP) Buenos Aires, Argentina. macchia@negrisud.it
Mariani
Javier
J
Comignani
Pablo Dino
PD
Fuselli
Juan José
JJ
Monte
Simona
S
Romero
Marilena
M
Tognoni
Gianni
G
D000740:Anemia / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D015897:Comorbidity; D006333:Heart Failure / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome