PMID- 19879457
OWN - NLM
STAT- MEDLINE
DCOM- 20100629
LR  - 20181201
IS  - 1532-8414 (Electronic)
IS  - 1071-9164 (Linking)
VI  - 15
IP  - 9
DP  - 2009 Nov
TI  - A pilot evaluation of the long-term effect of combined therapy with intravenous 
      iron sucrose and erythropoietin in elderly patients with advanced chronic heart 
      failure and cardio-renal anemia syndrome: influence on neurohormonal activation 
      and clinical outcomes.
PG  - 727-35
LID - 10.1016/j.cardfail.2009.05.010 [doi]
AB  - BACKGROUND: The prognosis in elderly patients with advanced chronic heart failure 
      (CHF) and cardio-renal anemia syndrome (CRAS) is ominous, and treatment 
      alternatives in this subset of patients are scarce. METHODS AND RESULTS: To 
      assess the long-term influence of combined therapy with intravenous (IV) iron and 
      erythropoietin (rHuEPO) on hemoglobin (Hb), natriuretic peptides (NT-proBNP), and 
      clinical outcomes in elderly patients with advanced CHF and mild-to-moderate 
      renal dysfunction and anemia (CRAS) who are not candidates for other treatment 
      alternatives, 487 consecutive patients were evaluated. Of them, 65 fulfilling 
      criteria for entering the study were divided into 2 groups and treated in an 
      open-label, nonrandomized fashion: intervention group (27, combined anemia 
      therapy) and control group (38, no treatment for anemia). At baseline, mean age 
      was 74 +/- 8 years, left ventricular ejection fraction was 34.5 +/- 14.1, Hb was 
      10.9 +/- 0.9 g/dL, creatinine was 1.5 +/- 0.5 mg/dL, NT-proBNP was 4256 +/- 4952 
      pg/mL, and 100% were in persistent New York Heart Association (NYHA) Class III or 
      IV. At follow-up (15.3 +/- 8.6 months), patients in the intervention group had 
      higher levels of hemoglobin (13.5 +/- 1.5 vs. 11.3 +/- 1.1; P < .0001), lower 
      levels of natural log of NT-proBNP (7.3 +/- 0.8 vs. 8.0 +/- 1.3, P = .016), 
      better NYHA functional class (2.0 +/- 0.6 vs. 3.3 +/- 0.5; P < .001), and lower 
      readmission rate (25.9% vs. 76.3%; P < .001). In the multivariate Cox 
      proportional hazards model, combined therapy was associated with a reduction of 
      the combined end point all-cause mortality or cardiovascular hospitalization (HR 
      95%CI 0.2 [0.1-0.6]; P < .001). CONCLUSION: Long-term combined therapy with IV 
      iron and rHuEPO may increase Hb, reduce NT-proBNP, and improve functional 
      capacity and cardiovascular hospitalization in elderly patients with advanced CHF 
      and CRAS with mild to moderate renal dysfunction.
FAU - Comin-Colet, Josep
AU  - Comin-Colet J
AD  - Department of Cardiology, Heart Failure Program, Hospital del Mar (IMAS), 
      Barcelona, Spain. jcomin@hospitaldelmar.cat
FAU - Ruiz, Sonia
AU  - Ruiz S
FAU - Cladellas, Merce
AU  - Cladellas M
FAU - Rizzo, Marcelo
AU  - Rizzo M
FAU - Torres, Adriana
AU  - Torres A
FAU - Bruguera, Jordi
AU  - Bruguera J
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20090627
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
RN  - 0 (Ferric Compounds)
RN  - 0 (Neurotransmitter Agents)
RN  - 0 (Recombinant Proteins)
RN  - 11096-26-7 (Erythropoietin)
RN  - FZ7NYF5N8L (Ferric Oxide, Saccharated)
RN  - QLZ991V4A2 (Glucaric Acid)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Anemia/blood/*drug therapy/mortality
MH  - Chronic Disease
MH  - Cohort Studies
MH  - Drug Evaluation
MH  - Drug Therapy, Combination
MH  - Erythropoietin/*administration & dosage
MH  - Female
MH  - Ferric Compounds/*administration & dosage
MH  - Ferric Oxide, Saccharated
MH  - Follow-Up Studies
MH  - Glucaric Acid
MH  - Heart Failure/blood/*drug therapy/mortality
MH  - Humans
MH  - Infusions, Intravenous
MH  - Kidney Failure, Chronic/blood/*drug therapy/mortality
MH  - Male
MH  - Neurotransmitter Agents/*blood
MH  - Pilot Projects
MH  - Prospective Studies
MH  - Recombinant Proteins
MH  - Survival Rate
MH  - Syndrome
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2009/11/03 06:00
MHDA- 2010/06/30 06:00
CRDT- 2009/11/03 06:00
PHST- 2008/10/08 00:00 [received]
PHST- 2009/05/04 00:00 [revised]
PHST- 2009/05/12 00:00 [accepted]
PHST- 2009/11/03 06:00 [entrez]
PHST- 2009/11/03 06:00 [pubmed]
PHST- 2010/06/30 06:00 [medline]
AID - S1071-9164(09)00169-9 [pii]
AID - 10.1016/j.cardfail.2009.05.010 [doi]
PST - ppublish
SO  - J Card Fail. 2009 Nov;15(9):727-35. doi: 10.1016/j.cardfail.2009.05.010. Epub 
      2009 Jun 27.