What benefits have been demonstrated with the use of erythropoietin-stimulating agents in patients with heart failure and anemia?
Small studies evaluating the treatment of anemia in patients with HF have suggested a trend toward improvement in functional capacity and reduction in hospitalization with the use of erythropoietin-stimulating agents,177 182 but results have varied183 and have been limited because of sample size. Although a meta-analysis of 11 RCTs (n=794) comparing erythropoietin-stimulating agents to control in patients with HF demonstrated significant improvements in 6-minute walk, exercise duration, peak Vo2 , NYHA functional status, EF, BNP, HF-related hospitalizations, and QoL,184 in the STAMINA-HeFT (Study of Anemia in Heart Failure) trial,183 darbepoetin alfa was not associated with significant clinical benefits.