A meta-analysis of erythropoiesis-stimulating agents in anaemic patients with chronic heart failure.
OBJECTIVE
Anaemia is a frequent comorbidity in patients with chronic heart failure (CHF) and is associated with worse outcomes. It is logical to consider whether correcting anaemia is a novel therapeutic target in such patients. We performed a meta-analysis to explore whether treatment of anaemia with erythropoietin-stimulating agents (ESA) can improve symptoms and progression in patients with CHF.


RESULTS
Studies were identified in English-language articles by searching PUBMED (inception to May 2009). A standardized protocol with predefined criteria was used to extract details on study design, Jadad score, demographic data, interventions, and outcomes. The main outcome measures were cardiac function, exercise capacity, quality of life, and all-cause mortality. Seven randomized controlled trials involving 678 patients were identified and included in the analysis. Cardiac function as well as exercise capacity were improved post-treatment in the ESA group; however, the overall deaths analysis demonstrated a lower trend but no significant protective effect in the ESA treatment group (RR, 0.71; 95% confidence interval, 0.41-1.24; P = 0.23).


CONCLUSIONS
This meta-analysis suggests a symptomatic improvement in anaemic patients with CHF receiving ESA. However, a non-significant reduction in all-cause mortality in the ESA treatment group compared with the control group was observed.
Jin
Bo
B
Department of Cardiology, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai 200040, China.
Luo
Xinping
X
Lin
Haihong
H
Li
Jian
J
Shi
Haiming
H
D000740:Anemia / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D015897:Comorbidity; D016001:Confidence Intervals; D017079:Exercise Tolerance; D006333:Heart Failure / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D016017:Odds Ratio; D011788:Quality of Life; D012306:Risk; D016896:Treatment Outcome
D006397:Hematinics