Abstract | BACKGROUND: METHODS AND RESULTS: We performed a post hoc analysis of the RED-HF trial (Reduction of Events by Darbepoetin Alfa in Heart Failure), in which 1008 patients with systolic heart failure and anemia ( hemoglobin level, 9.0-12.0 g/dL) were randomized to darbepoetin alfa. We examined the relationship between the hematopoietic response to darbepoetin alfa and the incidence of all-cause death or first heart failure hospitalization during a follow-up of 28 months. For the purposes of the present study, patients in the lowest quartile of hemoglobin change after 4 weeks were considered nonresponders. The median initial hemoglobin change in nonresponders (n=252) was -0.25 g/dL and +1.00 g/dL in the remainder of patients (n=756). Worse renal function, lower sodium levels, and less use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers were independently associated with nonresponse. Although a low endogenous erythropoietin level helped to differentiate responders from nonresponders, its predictive value in a multivariable model was poor (C statistic=0.69). Nonresponders had a higher rate of all-cause death or first heart failure hospitalization (hazard ratio, 1.25; 95% confidence interval, 1.02-1.54) and a higher risk of all-cause mortality (hazard ratio, 1.30; 95% confidence interval, 1.04-1.63) than responders. CONCLUSIONS: CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT00358215.
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Authors | Peter van der Meer, Niels Grote Beverborg, Marc A Pfeffer, Kurt Olson, Inder S Anand, B Daan Westenbrink, John J V McMurray, Karl Swedberg, James B Young, Scott D Solomon, Dirk J van Veldhuisen |
Journal | Circulation. Heart failure
(Circ Heart Fail)
Vol. 11
Issue 2
Pg. e004431
(02 2018)
ISSN: 1941-3297 [Electronic] United States |
PMID | 29367268
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © 2018 American Heart Association, Inc. |
Chemical References |
- Hematinics
- Darbepoetin alfa
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Topics |
- Aged
- Anemia
(complications, diagnosis, drug therapy)
- Darbepoetin alfa
(adverse effects, pharmacology)
- Female
- Heart Failure, Systolic
(complications, diagnosis, drug therapy)
- Hematinics
(pharmacology)
- Humans
- Male
- Middle Aged
- Prognosis
- Renal Insufficiency, Chronic
(drug therapy)
- Treatment Outcome
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