Iron deficiency contributes to resistance to endogenous erythropoietin in anaemic heart failure patients

Abstract

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