Insufficient evidence exists to evaluate effects of blood transfusions and iron therapy for treatment of anaemia in patients with heart disease--erythropoietin agonists do not improve outcomes

Commentary on: Kansagara D, Dyer E, Englander H, et al.. Treatment of anemia in patients with heart disease: a systematic review. Ann Intern Med 2013;159:746–57. Context The prevalence of anaemia ranges from 20% to 40% in patients with coronary heart disease (CHD) and is nearly 50% in patients with chronic heart failure (CHF). Anaemia is an independent predictor of poor clinical outcomes in patients with heart disease.1 2 Targeting anaemia to improve clinical outcomes is therefore a logical inference, with recent interest being largely driven by trials evaluating erythropoietin stimulating agents (ESAs) and one trial of intravenous iron therapy in CHF. Although recently reported Reduction of Events with Darbepoetin Alfa in Heart Failure (RED-HF) trial demonstrated no benefit of darbepoetin in CHF,3 clinical equipoise exists with regard to thresholds for blood transfusion and iron therapy in patients with heart disease. ...
Source: Evidence-Based Medicine - Category: Internal Medicine Authors: Tags: Clinical trials (epidemiology), Epidemiologic studies, Haematology (incl blood transfusion), Immunology (including allergy), Drugs: cardiovascular system, Hypertension, Ischaemic heart disease Therapeutics Source Type: research