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A meta‐analysis of erythropoiesis‐stimulating agents in anaemic patients with chronic heart failure
Author(s) -
Jin Bo,
Luo Xinping,
Lin Haihong,
Li Jian,
Shi Haiming
Publication year - 2010
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfp182
Subject(s) - medicine , jadad scale , heart failure , meta analysis , randomized controlled trial , comorbidity , confidence interval , erythropoietin , cardiac function curve , intensive care medicine , cochrane library
Aims Anaemia is a frequent comorbidity in patients with chronic heart failure (CHF) and is associated with worse outcomes. It is logical to consider whether correcting anaemia is a novel therapeutic target in such patients. We performed a meta‐analysis to explore whether treatment of anaemia with erythropoietin‐stimulating agents (ESA) can improve symptoms and progression in patients with CHF. Methods and results Studies were identified in English‐language articles by searching PUBMED (inception to May 2009). A standardized protocol with predefined criteria was used to extract details on study design, Jadad score, demographic data, interventions, and outcomes. The main outcome measures were cardiac function, exercise capacity, quality of life, and all‐cause mortality. Seven randomized controlled trials involving 678 patients were identified and included in the analysis. Cardiac function as well as exercise capacity were improved post‐treatment in the ESA group; however, the overall deaths analysis demonstrated a lower trend but no significant protective effect in the ESA treatment group (RR, 0.71; 95% confidence interval, 0.41–1.24; P = 0.23). Conclusion This meta‐analysis suggests a symptomatic improvement in anaemic patients with CHF receiving ESA. However, a non‐significant reduction in all‐cause mortality in the ESA treatment group compared with the control group was observed.