Erythropoietin in chronic heart failure

In patients with chronic heart failure (CHF), anemia is common and is associated with adverse outcome. Correction of anemia by erythropoiesis-stimulating proteins would thus seem attractive. Endogenous erythropoietin (Epo) levels are increased in CHF and are associated with severity of the disease a...

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Bibliographic Details
Published inCongestive heart failure (Greenwich, Conn.) Vol. 13; no. 5; p. 289
Main Authors Belonje, Anne M S, Voors, Adriaan A, van Gilst, Wiek H, van Veldhuisen, Dirk J
Format Journal Article
LanguageEnglish
Published United States 01.09.2007
Subjects
Apoptosis
Cardiotonic Agents
Disease Progression
Erythropoietin - pharmacology
Erythropoietin - therapeutic use
Heart Failure - drug therapy
Heart Failure - physiopathology
Humans
Neovascularization, Physiologic
Treatment Outcome
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Summary:In patients with chronic heart failure (CHF), anemia is common and is associated with adverse outcome. Correction of anemia by erythropoiesis-stimulating proteins would thus seem attractive. Endogenous erythropoietin (Epo) levels are increased in CHF and are associated with severity of the disease and with increased mortality. Furthermore, Epo levels poorly correlate with hemoglobin levels, suggesting that elevated Epo levels are not only driven by anemia, but by the condition of CHF as well. Several experimental studies have demonstrated ancillary cardioprotective effects of the recombinant form of Epo, including reduced apoptosis and increased neovascularization. Three early, small studies and 3 subsequent phase 2 trials found that erythropoiesis-stimulating proteins in anemic CHF patients were safe overall and potentially beneficial. Currently, a large phase 3, randomized, clinical trial is ongoing that evaluates the effects of darbepoetin alpha on morbidity and mortality in CHF.
ISSN:1527-5299
DOI:10.1111/j.1527-5299.2007.06662.x