© 2000 European Society of Cardiology
Serum erythropoietin in heart failure patients treated with ACE-inhibitors or AT1 antagonists
a Cardiology, Swiss Cardiovascular Center Bern, University Hospital CH-3010 Bern, Switzerland
b Clinic for Cardiovascular Surgery Bern, Switzerland
* Corresponding author. Tel.: 41-31-6322111; fax: 41-31-6324299. E-mail address: paul.mohacsi{at}insel.ch (P. Mohacsi).
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Abstract |
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Background: Erythropoietin (Epo), a growth factor produced by the kidney, is important in heart failure patients to promote oxygen delivery to tissues. Seventy-two chronic heart failure (CHF) patients at our outpatient clinic were subjected to morning serum Epo-level measurements and classified according to NYHA criteria.
Results: Forty-eight patients of classes III and IV had a significantly elevated serum Epo-level of 42.9±40.3 mIU/ml (mean±1 S.D.) when compared to the mean level of 24 patients of classes I and II who had a normal range mean value of 13.4±6.2 mIU/ml (P<0.05). Patients on angiotensin-converting enzyme (ACE) inhibitors showed a trend towards lower serum Epo-levels compared to patients treated with angiotensin-II type-1 receptor antagonists (AT1 antagonists) (levels: 33.3±35.6 mIU/ml and 43.6±38.1 mIU/ml). This trend did not, however, reach statistical significance (P=0.36).
Conclusion: We suggest that a desirable Epo increase in class III and IV CHF patients could be achieved by either recombinant human Epo administration or, possibly, by appropriate selection of the concomitant medical therapy. A large prospective study shall investigate the possible advantage of AT1 antagonists over ACE-inhibitors with regard to Epo effect.
Key Words: Heart failure • Anaemia • Erythropoietin • ACE-inhibitor • AT1 antagonists
Received January 5, 2000; Revised March 6, 2000; Accepted June 20, 2000
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