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Heart failure, general cardiology
Erythropoietin fails to improve outcomes in heart failure
Anaemia is common in patients with systolic heart failure and is associated with lower functional capacity, worse quality of life, and higher rates of hospitalisation and death. The cause of anaemia in these patients is often unclear but may be related to an absolute or relative deficiency of, or resistance to, erythropoietin. In this study Swedberg et al evaluated the effects of erythropoietin replacement with darbepoetin alfa on clinical outcomes in patients with systolic heart failure and anaemia.
In a multi-centre international randomised, double-blind trial, 2278 patients with systolic heart failure and mild-to-moderate anaemia (haemoglobin level, 9.0 to 12.0 g/dl) and no evidence of iron deficiency were randomised to receive either darbepoetin alfa (to achieve a haemoglobin target of 13 g/dl) or placebo. The primary outcome was a composite of death from any cause or hospitalisation for worsening heart failure.
The primary outcome occurred in 576 of 1136 patients (50.7%) in the darbepoetin group and 565 of 1142 patients (49.5%) in the placebo group (HR in the darbepoetin group, 1.01; 95% CI 0.90 to 1.13; p=0.87). There was no significant between-group difference in any of the secondary outcomes which included death, hospitalisation and a quality of life index. The neutral …