Abstract:
BACKGROUND:Anemia is now recognized as being a common finding in CHF and is associated with increased mortality and morbidity. However, it is uncertain whether the anemia is actually causing the worse prognosis or is merely a marker of more severe cardiac disease. Previous intervention studies with subcutaneous (s.c.) beta-EPO in combination with iron have either been uncontrolled or case-controlled studies. We report a randomized, double-blind, placebo-controlled study of the combination of s.c. EPO and oral iron versus oral iron alone in patients with anemia and resistant CHF. OBJECTIVES:The present study examines, in patients with advanced congestive heart failure (CHF) and anemia, the effects of beta-erythropoietin (EPO) and oral iron on the anemia and on cardiac and renal functional parameters. METHODS:Forty consecutive subjects with moderate to severe CHF and anemia (hemoglobin [Hb] <11 g/dL) were studied. They were randomized to receive, in a double-blind fashion, either (a) (group A, the treatment group, 20 patients) s.c. beta-EPO for 3 months twice weekly, in addition to daily oral iron, or (b) (group B, the placebo group, 20 patients) normal saline in s.c. injections and daily oral iron. Two patients in group B were eventually excluded because of a fall of Hb <8 g/dL requiring transfusion, leaving 18 patients in group B. After the 3-months study, the group A patients were maintained on the same treatment for an additional 9 months, whereas in Group B, the placebo and oral iron were stopped. RESULTS:In group A, after a mean of 3.5 +/- 0.8 months of treatment, there was a significant increase in Hb from 10.4 +/- 0.6 to 12.4 +/- 0.8 g/dL (P < .01); a significant improvement in New York Heart Association functional class from 3.5 +/- 0.6 to 2.8 +/- 0.5 (P < .05); a longer endurance time on exercise testing, from 5.8 +/- 2.2 to 7.8 +/- 2.5 minutes (P < .01); a greater distance walked on exercise testing, from 278 +/- 55 to 356 +/- 88 meters (P < .01); a significant increase in the peak oxygen consumption (VO2) from 12.8 +/- 2.8 to 15.1 +/- 2.8 mL/kg per minute (<.05); and the VO2 at the anaerobic threshold, from 9.2 +/- 2.0 to 13.2 +/- 3.6 mL/kg minute (P < .01). There was also a significant fall in plasma B-type natriuretic peptide levels from 568 +/- 320 to 271 +/- 120 pg/mL (P < .01), a significant reduction in serum creatinine (P < .01), and an increase in estimated creatinine clearance (P < .05). In group B, there were no significant changes in any of the above parameters over the study period. At the end of the 1-year study, the Hb was still higher in group A than group B, and the rate of hospital admissions/patients over the year averaged 0.8 +/- 0.2 in group A and 1.7 +/- 0.8 in group B (P < .01). CONCLUSIONS:In anemic CHF patients, correction of anemia with EPO and oral iron leads to improvement in New York Heart Association status, measured exercise endurance, oxygen use during exercise, renal function and plasma B-type natriuretic peptide levels and reduces the need for hospitalization.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Palazzuoli A,Silverberg D,Iovine F,Capobianco S,Giannotti G,Calabrò A,Campagna SM,Nuti Rdoi
10.1016/j.ahj.2006.08.005subject
Has Abstractpub_date
2006-12-01 00:00:00pages
1096.e9-15issue
6eissn
0002-8703issn
1097-6744pii
S0002-8703(06)00738-1journal_volume
152pub_type
杂志文章,随机对照试验abstract::To investigate the mechanisms of restenosis and detect useful interventions to prevent it, reliable quantitative measurements must be evaluated. Coronary arteries of domestic and minipigs (n = 18) were mechanically injured by balloon overstretching and killed at different intervals (2 to 25 weeks) after quantitative a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90531-d
更新日期:1993-12-01 00:00:00
abstract::The syndrome of fever and pericarditis is reported following implantation of a transvenous pacemaker in a 72-year-old man. The pacemaker was placed for prophylactic reasons (i.e., presence of bifascicular block). The syndrome resolved spontaneously after over four weeks of fever and a pericardial friction rub. Perfora...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90227-6
更新日期:1975-11-01 00:00:00
abstract::The development of ECG Minnesota Q-QS codes and their subsequent evolution were studied in the first 692 subjects to enter the POSCH program who had had one MI. The mean interval from MI to entry into the study was 2.2 years. Sixty-three percent of the subjects developed the most significant code with the infarction. ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(85)90169-3
更新日期:1985-08-01 00:00:00
abstract::The records of 64 patients with progressive systemic sclerosis (PSS) were reviewed. More than 100 items from the patient's history, physical examination, and laboratory tests were encoded. A two-tailed Gehan's test was used to evaluate the effect of each variable on patient survival. Variables significant at the 0.05 ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90525-3
更新日期:1985-07-01 00:00:00
abstract:BACKGROUND:Although angiotensin-converting enzyme inhibitor attenuates ventricular enlargement, whether beta-blocker therapy induces regression of left ventricular remodeling is not known. The purpose of this study was to compare the effects of bisoprolol therapy with those of imidapril therapy on left ventricular remo...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1067/mhj.2000.110934
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:The randomized BASKET-PROVE study showed no significant differences between sirolimus-eluting stents (SES), everolimus-eluting stents (EES), and bare-metal stents (BMS) with respect to the primary end point, rates of death from cardiac causes, or myocardial infarction (MI) at 2 years of follow-up, in patient...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2015.11.007
更新日期:2016-03-01 00:00:00
abstract:AIMS:There is a growing concern about the occurrence of coronary artery aneurysms (CAAs) after drug-eluting stent (DES) implantation and their long-term course. We assessed the occurrence and the factors affecting the long-term outcome of DES-associated CAA. METHODS AND RESULTS:We analyzed 3,612 consecutive patients (...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2010.07.013
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:The Total Occlusion Study of Canada (TOSCA) is a multicenter, randomized trial evaluating the effect of stenting with > =1 heparin-coated stent on long-term patency after percutaneous coronary intervention by balloon angioplasty of occluded coronary arteries. The purpose of the current study was to compare t...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1067/mhj.2001.116960
更新日期:2001-08-01 00:00:00
abstract::Histological study of the sinoatrial node (SAN) was performed in 111 patients in order to estabilsh correlations between the ECG findings and the anatomical lesions. This series includes both patients with sinus rhythm and patients with atrial arrhythmias. The results are as fololows: (a) the amount of nodal cells in ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80070-7
更新日期:1977-06-01 00:00:00
abstract::To investigate the significance and mechanism of dilatation of the left ventricular cavity on dipyridamole thallium-201 imaging, we performed both dipyridamole thallium-201 imaging and dipyridamole radionuclide angiography on 83 patients with known angiograms. The dipyridamole/delayed ratio of the left ventricular dim...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90713-r
更新日期:1991-02-01 00:00:00
abstract:BACKGROUND:ISAR-REACT was a trial designed to evaluate whether the glycoprotein IIb/IIIa inhibitor abciximab is beneficial in patients undergoing elective percutaneous coronary intervention (PCI) with stent placement after pretreatment with a 600 mg loading dose of clopidogrel. Objective for the angiographic substudy w...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2005.08.002
更新日期:2006-06-01 00:00:00
abstract::Patients with intractable heart failure (New York Heart Association [NYHA] class III and IV) who were receiving maximal conventional treatment were enrolled in an outpatient program that included inotropic infusions, intensive patient education, and close follow-up. The effects of this approach to therapy were evaluat...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90315-4
更新日期:1996-10-01 00:00:00
abstract::The amount of cross-sectional area narrowing by atherosclerotic plaques in each 5 mm long sement of the left main, left anterior descending, left circumflex, and right coronary arteries was analyzed at necropsy in 15 patients with type II hyperlipoproteinemia (HLP), in 13 with type IV HLP, and in 10 with known normal ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90383-5
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:Coronary calcium detected noninvasively is an attractive way to diagnose atherosclerosis before the development of symptoms. This study examines the prognostic value of coronary calcium in asymptomatic subjects with usual cardiovascular risk. METHODS AND RESULTS:In 425 asymptomatic subjects, 229 men (aged 4...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2003.169
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND:A large proportion of patients with heart failure (HF) have a large and poorly contracting left ventricle. The noninvasive recognition of the ischemic etiology of such patients is difficult, and for this purpose, usually patients undergo coronary angiography. It has been shown that cardiovascular magnetic re...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.03.068
更新日期:2006-01-01 00:00:00
abstract::This study was performed to assess the relation between the regional work and oxidative metabolism in hypertrophic cardiomyopathy (HCM). By using carbon 11 acetate as a tracer of myocardial blood flow (%A(0)) and oxygen consumption (k value), 12 patients with HCM with asymmetric septal hypertrophy and 10 normal subjec...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70143-1
更新日期:1997-05-01 00:00:00
abstract::We studied 56 right ventricular papillary muscles isolated from cats to determine whether the direct mechanical effects of contrast media are due to their pharmacologic action or to the hyperosmolality caused by them. A 10% solution of Renografin-76 abruptly decreased force 22% below control, then slowly increased it ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90550-7
更新日期:1984-07-01 00:00:00
abstract::Cardiac pacing initiated from epicardial or transvenous apical right ventricular electrodes causes asynchronous ventricular contraction. This alters myocardial stress vectors and results in adverse cellular and subcellular changes in the experimental animal. Clinically, such changes may contribute to the adverse hemod...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90195-n
更新日期:1991-03-01 00:00:00
abstract::The objective of this investigation was to assess the acute and long-term outcome after coronary angioplasty in patients undergoing chronic hemodialysis. Previous studies have suggested a high incidence of restenosis after coronary angioplasty performed in patients with renal failure. Medical discharge abstracts for 8...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90476-6
更新日期:1994-08-01 00:00:00
abstract:BACKGROUND:Strenuous exercise can be a major trigger for coronary thrombosis and it enhances platelet aggregation. METHODS:We evaluated the effect of antiplatelet therapy on shear stress-induced platelet aggregation (SIPA), in addition to agonist-induced aggregation, before and immediately after ergometer exercise in ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mhj.2001.116485
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:Apparent treatment-resistant hypertension (aTRH) is associated with an increased risk of adverse cardiovascular outcomes. We studied the frequency and intensity of care for aTRH among participants aged 65 years and older in the US-based REGARDS study linked with Medicare claims. METHODS:Blood pressure (BP) ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2017.01.008
更新日期:2017-04-01 00:00:00
abstract::Despite gratifying immediate results, significant recoarctation at follow-up has been observed after balloon angioplasty of native aortic coarctation. Risk factors for such recurrences have been identified in one of our previous studies. In this study we examined the value of these risk factors in the prediction of re...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90245-7
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVE:To assess whether serum uric acid, which is a marker of impaired oxidative metabolism, might correlate with left ventricular systolic and diastolic dysfunction in patients with chronic heart failure (CHF). BACKGROUND:Uric acid levels, which are frequently elevated in patients with CHF, correlate with leg vas...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.122122
更新日期:2002-06-01 00:00:00
abstract::Reductions in mobility and cognitive function linked to accrual of brain microvascular disease related white matter hyperintensities (WMHs) on magnetic resonance imaging can occur in older hypertensive patients in as little as 2 years. We have designed a trial evaluating 2 levels of ambulatory blood pressure (ABP) con...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2012.11.008
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:The recent North American and European practice guidelines in patients with non-ST-segment elevation acute coronary syndrome (nSTE ACS) recommend glycoprotein IIb/IIIa (GpIIb-IIIa) inhibition in patients undergoing an early invasive treatment strategy. However, the guidelines are not explicit regarding the t...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.03.029
更新日期:2005-06-01 00:00:00
abstract::The development of a group of calcium channel blockers that prolong the QT interval has raised interest in their possible proarrhythmic potential. In animal experiments lidoflazine has no observed arrhythmogenic potential and no antiarrhythmic potential in a model sensitive to the antiarrhythmic properties of both con...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90628-3
更新日期:1985-02-01 00:00:00
abstract::The prevention of major bleeding during percutaneous coronary intervention is one of the most widely discussed and often controversial topics within interventional cardiology. The choice of arterial access should be considered a mechanism for bleeding avoidance, and various strategies have been proposed to prevent or ...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2015.04.023
更新日期:2015-07-01 00:00:00
abstract::Ambulatory ECG recordings were obtained from 313 consecutive, totally symptom-free male subjects on whom cardiac catheterization was subsequently performed for occupational reasons. These recordings were examined for ventricular ectopy and the results were studied in relation to the findings on selective coronary angi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90405-5
更新日期:1989-06-01 00:00:00
abstract::To examine the relationship between the improvement of wall motion in infarcted regions after percutaneous transluminal coronary angioplasty (PTCA) and thallium-201 uptake in the delayed image of exercise thallium-201 scintigraphy before PTCA, 14 patients with anterior old myocardial infarction were studied. Exercise ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90053-c
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Kidney failure causes anemia and is associated with a very high risk of coronary heart disease (CHD). Mildly to moderately decreased kidney function is far more common and also is associated with an elevated prevalence of anemia and CHD risk. Recent data suggest an even higher risk of CHD when both condition...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.03.055
更新日期:2006-02-01 00:00:00