Document Detail


Impact of erythropoiesis-stimulating agents on morbidity and mortality in patients with heart failure: an updated, post-TREAT meta-analysis.
MedLine Citation:
PMID:  20525985     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Randomized clinical trials have suggested that treatment of anaemia with erythropoiesis-stimulating agents (ESAs) in patients with cancer or chronic kidney disease may increase cardiovascular risk. We therefore examined the effect of treating anaemia with an ESA in patients with heart failure in a meta-analysis of randomized clinical trials, including the recently reported TREAT study.
METHODS AND RESULTS: We performed a systematic review and meta-analysis of all prospective, randomized, controlled studies of ESAs enrolling patients with heart failure and reporting data on mortality or non-fatal heart failure events. Of 10 trials initially identified by our search strategy, we pooled data from 9 placebo-controlled studies enrolling a total of 2039 patients, of whom 1023 (50.2%) were allocated to ESA treatment. The pooled risk ratio for ESA treatment relative to placebo was 1.03 [95% confidence interval (CI): 0.89-1.21, P = 0.68] for overall mortality and 0.95 (95% CI: 0.82-1.10, P = 0.46) for worsening heart failure.
CONCLUSIONS: The use of ESAs to manage anaemia in patients with heart failure was associated with a neutral effect on both mortality and non-fatal heart failure events. Definitive assessment of the balance of risk and benefit in this population awaits the completion of a randomized clinical trial adequately powered to assess clinical outcomes.
Authors:
Akshay Desai; Eldrin Lewis; Scott Solomon; John J V McMurray; Marc Pfeffer
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review     Date:  2010-06-05
Journal Detail:
Title:  European journal of heart failure     Volume:  12     ISSN:  1879-0844     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-23     Completed Date:  2011-01-11     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  936-42     Citation Subset:  IM    
Affiliation:
Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA. adesai@partners.org
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MeSH Terms
Descriptor/Qualifier:
Anemia / complications,  drug therapy*
Heart Failure / complications,  epidemiology*
Hematinics / therapeutic use*
Humans
Morbidity / trends
Prognosis
Survival Rate / trends
Chemical
Reg. No./Substance:
0/Hematinics

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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