PMID- 11401110
OWN - NLM
STAT- MEDLINE
DCOM- 20010809
LR  - 20220408
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 37
IP  - 7
DP  - 2001 Jun 1
TI  - The effect of correction of mild anemia in severe, resistant congestive heart 
      failure using subcutaneous erythropoietin and intravenous iron: a randomized 
      controlled study.
PG  - 1775-80
AB  - OBJECTIVES: This is a randomized controlled study of anemic patients with severe 
      congestive heart failure (CHF) to assess the effect of correction of the anemia 
      on cardiac and renal function and hospitalization. BACKGROUND: Although mild 
      anemia occurs frequently in patients with CHF, there is very little information 
      about the effect of correcting it with erythropoietin (EPO) and intravenous iron. 
      METHODS: Thirty-two patients with moderate to severe CHF (New York Heart 
      Association [NYHA] class III to IV) who had a left ventricular ejection fraction 
      (LVEF) of < or =40% despite maximally tolerated doses of CHF medications and 
      whose hemoglobin (Hb) levels were persistently between 10.0 and 11.5 g% were 
      randomized into two groups. Group A (16 patients) received subcutaneous EPO and 
      IV iron to increase the level of Hb to at least 12.5 g%. In Group B (16 patients) 
      the anemia was not treated. The doses of all the CHF medications were maintained 
      at the maximally tolerated levels except for oral and intravenous (IV) 
      furosemide, whose doses were increased or decreased according to the clinical 
      need. RESULTS: Over a mean of 8.2+/-2.6 months, four patients in Group B and none 
      in Group A died of CHF-related illnesses. The mean NYHA class improved by 42.1% 
      in A and worsened by 11.4% in B. The LVEF increased by 5.5% in A and decreased by 
      5.4% in B. The serum creatinine did not change in A and increased by 28.6% in B. 
      The need for oral and IV furosemide decreased by 51.3% and 91.3% respectively in 
      A and increased by 28.5% and 28.0% respectively in B. The number of days spent in 
      hospital compared with the same period of time before entering the study 
      decreased by 79.0% in A and increased by 57.6% in B. CONCLUSIONS: When anemia in 
      CHF is treated with EPO and IV iron, a marked improvement in cardiac and patient 
      function is seen, associated with less hospitalization and renal impairment and 
      less need for diuretics.
FAU - Silverberg, D S
AU  - Silverberg DS
AD  - Department of Nephrology and Cardiology and Congestive Heart Failure Program, Tel 
      Aviv Medical Center, Israel.
FAU - Wexler, D
AU  - Wexler D
FAU - Sheps, D
AU  - Sheps D
FAU - Blum, M
AU  - Blum M
FAU - Keren, G
AU  - Keren G
FAU - Baruch, R
AU  - Baruch R
FAU - Schwartz, D
AU  - Schwartz D
FAU - Yachnin, T
AU  - Yachnin T
FAU - Steinbruch, S
AU  - Steinbruch S
FAU - Shapira, I
AU  - Shapira I
FAU - Laniado, S
AU  - Laniado S
FAU - Iaina, A
AU  - Iaina A
LA  - eng
PT  - Case Reports
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 11096-26-7 (Erythropoietin)
RN  - E1UOL152H7 (Iron)
SB  - IM
MH  - Aged
MH  - Anemia/*complications/*drug therapy
MH  - Erythropoietin/*administration & dosage
MH  - Female
MH  - Heart Failure/*complications/*drug therapy
MH  - Humans
MH  - Injections, Intravenous
MH  - Injections, Subcutaneous
MH  - Iron/*administration & dosage
MH  - Male
MH  - Prospective Studies
MH  - Severity of Illness Index
EDAT- 2001/06/13 10:00
MHDA- 2001/08/10 10:01
CRDT- 2001/06/13 10:00
PHST- 2001/06/13 10:00 [pubmed]
PHST- 2001/08/10 10:01 [medline]
PHST- 2001/06/13 10:00 [entrez]
AID - S0735-1097(01)01248-7 [pii]
AID - 10.1016/s0735-1097(01)01248-7 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2001 Jun 1;37(7):1775-80. doi: 10.1016/s0735-1097(01)01248-7.