Despite advances in chronic heart failure (CHF) medical and device therapy in recent
years, CHF continues to be a syndrome associated with significant morbidity and mortality.
Abundance of data suggests that anemia is prevalent in CHF. The pathophysiology of
CHF-related anemia is complex and poorly understood. Earlier small trials demonstrated
improvement in morbidity with use of erythropoietin stimulating agents (ESA) and parenteral
iron but that was not supported by more recent large randomized trials. There is a
concern regarding the safety of ESA. Small studies showed benefits from parenteral
iron alone or combination with ESA. This was promising since parenteral iron is a
relatively cheap therapeutic intervention to treat anemia in CHF patients. So far
there are no clear recommendations regarding the treatment of CHF related anemia.
The purpose of this article is to review the most recent epidemiology, pathophysiology,
and therapeutic options for anemia in CHF.
Key-words:
Chronic heart failure - anemia - erythropoietin and iron
