4 research outputs found
Iron deficiency contributes to resistance to endogenous erythropoietin in anaemic heart failure patients
Aims Abnormal endogenous erythropoietin (EPO) constitutes an important cause of anaemia in chronic diseases. We analysed the relationships between iron deficiency (ID) and the adequacy of endogenous EPO in anaemic heart failure (HF) patients, and the impact of abnormal EPO on 12-month mortality. Methods and results We investigated 435 anaemic HF patients (age: 74 +/- 10 years; males: 60%; New York Heart Association class I or II: 39%; left ventricular ejection fraction: 43 +/- 17%). Patients with EPO higher than expected for a given haemoglobin were considered EPO-resistant whereas those with EPO lower than expected - EPO-deficient. ID was defined as serum ferriti
EFFECTS OF INTRAVENOUS IRON THERAPY IN IRON DEFICIENT PATIENTS WITH SYSTOLIC HEART FAILURE: META-ANALYSIS OF RANDOMIZED CONTROL TRIALS
Effects of intravenous iron therapy in iron-deficient patients with systolic heart failure: a meta-analysis of randomized controlled trials
The aim of this study was to assess the net clinical and prognostic
effects of intravenous (i.v.) iron therapy in patients with systolic
heart failure (HF) and iron deficiency (ID). We performed an aggregate
data meta-analysis (random effects model) of randomized controlled
trials that evaluated the effects of i.v. iron therapy in iron-deficient
patients with systolic HF. We searched electronic databases up to
September 2014. We identified five trials which fulfilled the inclusion
criteria (509 patients received i.v. iron therapy in comparison with 342
controls). Intravenous iron therapy has been shown to reduce the risk of
the combined endpoint of all-cause death or cardiovascular
hospitalization [odds ratio (OR) 0.44, 95% confidence interval (CI)
0.30-0.64, P < 0.0001], and the combined endpoint of cardiovascular
death or hospitalization for worsening HF (OR 0.39, 95% CI 0.24-0.63, P
= 0.0001). Intravenous iron therapy resulted in a reduction in NYHA
class (data are reported as a mean net effect with 95% CIs for all
continuous variables) (-0.54 class, 95% CI -0.87 to -0.21, P = 0.001);
an increase in 6-min walking test distance (+31 m, 95% CI 18-43, P <
0.0001); and an improvement in quality of life [Kansas City
Cardiomyopathy Questionnaire (KCCQ) score +5.5 points, 95% CI 2.8-8.3,
P < 0.0001; European Quality of Life-5 Dimensions (EQ-5D) score +4.1
points, 95% CI 0.8-7.3, P = 0.01; Minnesota Living With Heart Failure
Questionnaire (MLHFQ) score -19 points, 95% CI:-23 to -16, P < 0.0001;
and Patient Global Assessment (PGA) +0.70 points, 95% CI 0.31-1.09, P =
0004]. The evidence indicates that i.v. iron therapy in iron-deficient
patients with systolic HF improves outcomes, exercise capacity, and
quality of life, and alleviates HF symptoms
Iron deficiency contributes to resistance to endogenous erythropoietin in anaemic heart failure patients
Aims Abnormal endogenous erythropoietin (EPO) constitutes an important cause of anaemia in chronic diseases. We analysed the relationships between iron deficiency (ID) and the adequacy of endogenous EPO in anaemic heart failure (HF) patients, and the impact of abnormal EPO on 12-month mortality. Methods and results We investigated 435 anaemic HF patients (age: 74 +/- 10 years; males: 60%; New York Heart Association class I or II: 39%; left ventricular ejection fraction: 43 +/- 17%). Patients with EPO higher than expected for a given haemoglobin were considered EPO-resistant whereas those with EPO lower than expected - EPO-deficient. ID was defined as serum ferritin</p