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. 2016;12(3):247-53.
doi: 10.5114/aic.2016.61647. Epub 2016 Aug 19.

Effects of erythropoiesis-stimulating agents on heart failure patients with anemia: a meta-analysis

Hengliang Zhang  1 , Pei Zhang  1 , Yaheng Zhang  1 , Junqiang Yan  1 , Pingshuan Dong  1 , Yanyu Wang  1 , Xiaowei Niu  2
Affiliations

Effects of erythropoiesis-stimulating agents on heart failure patients with anemia: a meta-analysis

Hengliang Zhang et al. Postepy Kardiol Interwencyjnej. 2016.

Abstract

Introduction: Heart failure (HF) is always complicated with anemia and is associated with bad prognosis in this patient population. Several studies have assessed the potential role of erythropoietin-stimulating agent (ESA) in improving cardiac function and reducing the number of hospitalizations in anemic patients with HF.

Aim: We performed a meta-analysis to assess the potential role of ESA in the treatment of anemic patients with HF.

Material and methods: A literature and Medline search was performed to identify studies with control groups that examined the efficacy of ESA therapy in patients with HF and anemia.

Results: A total of 11 studies were included (n = 3044 subjects) in the final analysis. Compared to placebo, ESA therapy was associated with increased hemoglobin levels (1.89 g/dl; 95% CI: 1.64-2.14, p < 0.00001), increased left ventricular ejection fraction (LVEF) to 6.88 (95% CI: 0.49-13.28, p = 0.03), decreased B-type natriuretic protein (-272.20; 95% CI: (-444.52)-(-99.89), p = 0.002), improvement in New York Heart Association functional class to -0.33 mean difference (95% CI: (-0.44)-(-0.23), p < 0.00001), and decreased hospitalization (OR = 0.61, 95% CI: 0.39-0.94, p = 0.02). There was no significant between-group difference in all-cause mortality (OR = 0.78, 95% CI: 0.51-1.21, p = 0.27).

Conclusions: The treatment of anemia with ESA therapy did not reduce the rate of all-cause mortality among patients with heart failure, but ESA therapy made a potential important contribution to patients' symptomatic improvement.

Keywords: anemia; erythropoietin-stimulating agents; heart failure; meta-analysis; randomized controlled trials.

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Figures

Figure 1
Figure 1
Process of study selection. Flowchart shows the literature search process and the final number of studies included
Figure 2
Figure 2
Effects of erythropoiesis-stimulating agent therapy in heart failure patients with anemia at follow-up compared to baseline
Figure 3
Figure 3
Effect of erythropoiesis-stimulating agent therapy on hospitalizations and mortality
See this image and copyright information in PMC

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