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Anemia in Cardiovascular Disease: Marker of Disease Severity or Disease-modifying Therapeutic Target?

  • Coronary Heart Disease (S. Virani and S. Naderi, Section Editors)
  • Published:
Current Atherosclerosis Reports Aims and scope Submit manuscript

Abstract

Purpose of the Review

In this review paper, we examine the latest evidence regarding the use of iron supplementation, erythropoiesis-stimulating agents (ESAs), and blood transfusions as therapeutic targets for anemia to mitigate morbidity and mortality in patients with cardiovascular disease.

Recent Findings

Intravenous ferric carboxymaltose (FC) injections in heart failure (HF) have resulted in improved self-reported patient symptoms; higher exercise capacity, as measured by 6-min walk test distance in anemic patients; and lower re-hospitalization rates in iron deficient patients. Darbepoetin alfa has shown evidence of improved Kansas City Cardiomyopathy Questionnaire scores. No mortality benefits have been noted thus far with FC injections or darbepoetin in HF, with an increase in adverse events with darbepoetin. Aggressive transfusions (Hg < 10 g/dL) are not associated with improved outcomes in cardiovascular disease.

Summary

Quality of life metrics, rather than mortality, appear to improve with IV FC and ESA use in HF. More studies are required to see if these treatments have a role in coronary artery disease. Current evidence suggests that anemia is a marker of underlying disease severity, with a limited role in disease modification. Further studies are required to solidify our understanding of this topic.

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Acknowledgements

We thank Ann Sutton, Research Medical Library, for editing this article.

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  1. Harsh Goel, Joshua R. Hirsch, and Anita Deswal Contributed equally to this work.

Authors and Affiliations

  1. Department of Internal Medicine, The University of Texas Health Science Center, Houston, TX, USA

    Harsh Goel

  2. Division of Internal Medicine, Baylor College of Medicine, Houston, TX, USA

    Joshua R. Hirsch

  3. Department of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA

    Anita Deswal & Saamir A. Hassan

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Goel, H., Hirsch, J.R., Deswal, A. et al. Anemia in Cardiovascular Disease: Marker of Disease Severity or Disease-modifying Therapeutic Target?. Curr Atheroscler Rep 23, 61 (2021). https://doi.org/10.1007/s11883-021-00960-1

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