© 2007 European Society of Cardiology
Are erythropoietin stimulating proteins safe and efficacious in heart failure? Why we need an adequately powered randomised outcome trial
Department of Cardiology, University Medical Center Groningen, University of Groningen PO Box 30.001, 9700RB Groningen, The Netherlands. E-maill address: d.j.van.veldhuisen@thorax.umcg.nl Tel.: +31 50 3612355; fax: +31 50 3614391.
Department of Cardiology, Western Infirmary Glasgow, UK
Received January 11, 2007;
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1. Introduction |
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Following the development of recombinant erythropoietin in the 1980's, its use to treat anaemia in patients with chronic kidney disease (CKD) has increased markedly over the last two decades [1]. Subsequently, the prevalence of anaemia has been found to be high in patients with chronic heart failure (CHF), in whom it is an independent predictor of poor outcome [2]. Consequently, there has also been recent interest in erythropoiesis stimulating proteins (ESPs) as a treatment in CHF [3,4] One such agent, darbepoetin alfa, is currently being tested in a large-scale, phase III morbidity and mortality trial: the Reduction of Events with Darbepoetin alfa in Heart Failure (RED-HF) [5].
Recently, concerns about the cardiovascular safety of ESPs have been raised. On November 16, 2006, two separate studies, Correction of Hemoglobin and Outcomes in Renal Insufficiency (CHOIR) [6] and Cardiovascular Risk reduction by Early Anemia Treatment with Epoetin
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2. CREATE and CHOIR |
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3. Prior evidence about the effects of ESPs in chronic heart failure |
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4. Evidence from other trials |
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5. Summary and implications of CHOIR and CREATE for RED-HF |
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