MECHANISMS OF ANEMIA IN CHRONIC HEART FAILURE POINT TO APPROPRIATE TREATMENT

Medscape news

Euro Heart J 2005;26:2213-2214,2232-2237.

NEW YORK (Reuters Health) Dec 02 - Researchers from Italy report that blunted erythropoietin production and defective iron supply for erythropoiesis are "major causes" of anemia in patients with chronic heart failure. The findings suggest that erythropoietic drugs and iron add-back therapy may have beneficial effects in this patient population.

Anemia is often seen in heart failure patients and it may be associated with a poor prognosis but little is known about its origins, Dr. Cristina Opasich from the Institute of Pavia and colleagues explain in the November issue of the European Heart Journal.

To identify mechanisms of anemia in chronic heart failure, they studied 148 consecutive anemic heart failure patients. The men in the study had hemoglobin concentrations < 13 g/dL whereas the women had hemoglobin levels < 12 g/dL.

According to the team, "poor utilization of seemingly adequate iron stones, excessive cytokines activation, and inhibited synthesis of erythropoietin were common, suggesting that these are probably the most important factors closely connected with anemia in chronic disease. They were found in 57% of our population."

The authors of a related editorial contend that the therapeutic ramifications of this study are "important." The data presented "suggest that erythropoietic agents and iron therapy are rational treatment options for the amelioration of anemia in a significant proportion of anemic chronic heart failure patients," Dr. Darlington O. Okonko from the Imperial College School of Medicine in London and colleagues propose.

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