Abstract:
BACKGROUND:Anemia in heart failure is both common and associated with worse symptoms and increased mortality. Several small randomized controlled trials (RCTs) have assessed erythropoiesis-stimulating agents (ESAs), but definitive evaluation and clinical guidance are required. We sought to systematically review the effects of ESAs in chronic heart failure. METHODS:An extensive search strategy identified 11 RCTs with 794 participants comparing any ESA with control over 2 to 12 months of follow-up. Published and additionally requested data were incorporated into a Cochrane systematic review (CD007613). RESULTS:Nine studies were placebo controlled, and 5, double blinded. Erythropoiesis-stimulating agent treatment significantly improved exercise duration by 96.8 seconds (95% CI 5.2-188.4, P = .04) and 6-minute walk distance by 69.3 m (95% CI 17.0-121.7, P = .009) compared with control. Benefit was also noted for peak oxygen consumption (+2.29 mL/kg per minute, P = .007), New York Heart Association class (-0.73, P < .001), ejection fraction (+5.8%, P < .001), B-type natriuretic peptide (-226.99 pg/mL, P < .001), and quality-of-life indicators with a mean increase in hemoglobin level of 2 g/dL. There was a significantly lower rate of heart failure-related hospitalizations with ESA therapy (odds ratio 0.56, 95% CI 0.37-0.84, P = .005). No associated increase in adverse events or mortality (odds ratio 0.58, 95% CI 0.34-0.99, P = .047) was observed, although the number of events was limited. CONCLUSION:Meta-analysis of small RCTs suggests that ESA treatment can improve exercise tolerance, reduce symptoms, and have benefits on clinical outcomes in anemic patients with heart failure. Confirmation requires larger, well-designed studies with careful attention to dose, attained hemoglobin level, and long-term outcomes.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Kotecha D,Ngo K,Walters JA,Manzano L,Palazzuoli A,Flather MDdoi
10.1016/j.ahj.2011.02.013subject
Has Abstractpub_date
2011-05-01 00:00:00pages
822-831.e2issue
5eissn
0002-8703issn
1097-6744pii
S0002-8703(11)00166-9journal_volume
161pub_type
杂志文章,meta分析,评审abstract:BACKGROUND:Parasympathetic dysautonomia is an established feature of advanced Chagas cardiomyopathy. However, in the absence of cardiac involvement, the presence of vagal dysfunction remains controversial. In a cross-sectional study, we compared patients with Chagas disease without cardiac involvement and healthy indiv...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.111406
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:The recovery of left ventricular function (LVF) after revascularization takes time. alpha-Adrenergic blockade acutely improves coronary blood flow and LVF, whereas the effects of more prolonged alpha-adrenergic blockade on LVF recovery after stenting are unknown. METHODS:In 32 patients (age 58 +/- 12 y) wit...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Accurate, reproducible, noninvasive determination of left ventricular (LV) volumes and ejection fraction (EF) is important for clinical assessment, risk stratification, selection of therapy, and serial monitoring of patients with cardiovascular disease. Three-dimensional echocardiography (3DE) approaches hav...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1067/mhj.2000.108513
更新日期:2000-09-01 00:00:00
abstract::This study attempted to define the role of endothelin (ET) in preconditioning. We previously showed that ET Is produced during myocardial ischemia and reperfusion. Because both preconditioning and ET act through protein kinase C, ET could play a role in preconditioning. Dogs were randomized to three groups subjected t...
journal_title:American heart journal
pub_type: 杂志文章
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abstract::Hypertensive cardiovascular risk may be related primarily to vascular overload, the sum of three vascular abnormalities: increased arteriolar resistance, increased large-artery stiffness, and the effect of increased early pulse-wave reflection. A method for quantifying vascular overload as an index can be derived from...
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pub_type: 杂志文章,随机对照试验
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更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Cardiac resynchronization therapy (CRT) is currently indicated in patients with moderate to severe heart failure, a wide QRS complex and significant left ventricular dysfunction despite optimal medical therapy. Adoption of these criteria for CRT results in a favorable response in only two thirds of candidate...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2004.12.013
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abstract::There is evidence that the endothelium plays an important role in the control of human vascular tone by releasing endothelium-derived nitric oxide and, therefore, a defective endothelial function could be involved in the increased peripheral vasoconstriction of patients with chronic congestive heart failure. To invest...
journal_title:American heart journal
pub_type: 杂志文章,评审
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abstract::In the United States there has been a dramatic decrease in age-adjusted coronary heart disease (CHD) mortality during the last 20 years. This article investigates the reasons for this decline and concludes that most of the decline in CHD has been the result of life-style changes, particularly reduction in serum choles...
journal_title:American heart journal
pub_type: 杂志文章,评审
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更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine the impact of myocardial perfusion imaging (MPI) on the outcomes of death, myocardial infarction (MI), and late coronary revascularization procedures. METHODS:In patients undergoing exercise-stress MPI (January 1, 2003-March 31, 2007), we determined the impact of summe...
journal_title:American heart journal
pub_type: 杂志文章
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journal_title:American heart journal
pub_type: 临床试验,杂志文章
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更新日期:2018-11-01 00:00:00
abstract::Although many patients with coronary artery disease (CAD) have a positive exercise test without pain, the frequency and significance of this "silent" ischemia is unclear. Therefore, we studied 122 consecutive clinically stable patients with angiographically defined CAD (greater than 75 per cent luminal stenosis) and a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(78)90234-x
更新日期:1978-04-01 00:00:00
abstract::Cardiopulmonary resuscitation-generated coronary perfusion pressure and intracoronary flow velocity was studied with high-fidelity pressure transducers and an intracoronary Doppler catheter in 11 swine undergoing closed-chest manual cardiopulmonary resuscitation. Retrograde coronary blood flow in the mid left anterior...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90622-x
更新日期:1994-09-01 00:00:00
abstract::In the Cardiovascular Measurement System (CMS) the edge-detection algorithm, which was primarily designed for the Philips digital cardiac imaging system (DCI), is applied to cinefilms. Comparative validation of CMS and DCI was performed in vitro and in vivo with intracoronary insertion of stenosis phantoms in anesthet...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)91045-g
更新日期:1993-08-01 00:00:00
abstract::The single-dose pharmacokinetics of amiodarone have been studied in volunteer subjects given 400 mg doses by the intravenous and oral routes. The data show the compound to have a very large volume of distribution, a low total clearance, and a long and variable terminal elimination half-life. In patients the terminal e...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90006-6
更新日期:1983-10-01 00:00:00
abstract:BACKGROUND:Previous studies have generated inconsistent results when attempting to define predictors of stroke and death in patients with endocarditis. We sought to examine the relationship between vegetation 2-dimensional size and stroke in those with infective endocarditis (IE) and to identify differences between aor...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.115790
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:The prevalence of renal disease in cardiac intensive care units (CICUs) is increasing, but little is known about the utilization, concurrent therapies, and outcomes of patients requiring acute renal replacement therapy (RRT) in this specialized environment. METHODS:In the Critical Care Cardiology Trials Net...
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pub_type: 杂志文章,多中心研究
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更新日期:2020-04-01 00:00:00
abstract::An angioplasty catheter was developed to allow measurement of absolute coronary blood flow during interventional procedures. This method uses electrical impedance changes induced by a 0.5 ml bolus of 5% dextrose solution and indicator-dilution principles. The indicator is injected through a port located just proximal ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90184-j
更新日期:1991-03-01 00:00:00
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pub_type: 杂志文章
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更新日期:2021-01-14 00:00:00
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更新日期:2014-07-01 00:00:00
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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
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更新日期:1998-10-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
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更新日期:1988-10-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70331-x
更新日期:1998-03-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90067-j
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Dual antiplatelet therapy with aspirin and clopidogrel is currently recommended in off-pump coronary artery bypass (OPCAB). However, no data exist concerning platelet reactivity on clopidogrel after OPCAB. The aim of this study was to assess the relationship between platelet reactivity and late major adverse...
journal_title:American heart journal
pub_type: 杂志文章
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更新日期:2014-06-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
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更新日期:1986-03-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2009-05-01 00:00:00
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pub_type: 杂志文章
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