Circulation. 2006;113:2454-2461
doi: 10.1161/CIRCULATIONAHA.105.583666
doi: 10.1161/CIRCULATIONAHA.105.583666
(Circulation. 2006;113:2454-2461.)
© 2006 American Heart Association, Inc.
Contemporary Reviews in Cardiovascular Medicine |
Anemia in Chronic Heart Failure
Prevalence, Etiology, Clinical Correlates, and Treatment Options
From the Department of Internal Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Conn.
Correspondence to Stuart D. Katz, MD, Yale Heart Failure and Transplant Center, Yale University School of Medicine, 135 College St, Suite 301, New Haven, CT 06510. E-mail stuart.katz@yale.edu
Key Words: anemia • exercise • heart failure • kidney • erythropoietin
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
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Introduction |
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Anemia occurs commonly in patients with chronic heart failure (CHF) and has been proposed as a novel therapeutic target in this patient population. The present review will summarize the current knowledge of the prevalence, causative factors, and pathophysiological correlates of anemia in CHF. Potential risks and benefits of therapy with erythropoietic agents for the treatment of anemia in CHF will also be discussed.
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Prevalence of Anemia in CHF |
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Estimates of the prevalence of anemia in patients with CHF and low ejection fraction range widely from 4% to 61% (median 18%).1–15 Variability in estimated prevalence is partly attributable to use of inconsistent definitions of anemia in individual reports. The World Health Organization definition of anemia (hemoglobin concentration <13.0 g/dL in men and <12.0 g/dL in women) takes into account known gender differences in distribution of hemoglobin values,16 whereas the National Kidney Foundation defines anemia as hemoglobin
12 g/dL in men and postmenopausal women.17 These standard definitions of anemia are not based on well-established physiological or population norms. Published reports in CHF populations have used these and other study-specific definitions of anemia (including other arbitrary or statistically defined hemoglobin and hematocrit categories and administrative diagnostic codes from hospital records). Despite these inconsistencies in the definition of anemia cases, most studies indicate that the prevalence of anemia is increased in CHF populations with comorbid kidney disease, advanced age, and more severe symptoms (range, 30% to 61%) when compared with less symptomatic ambulatory populations (range, 4% to 23%). In patients with CHF and preserved ejection fraction, the few published This article has been cited by other articles:
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