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|Issue 46||November 2011|
A Review of the Evidence: Treatment of Anemia in Patients with Heart Disease
Anemia is very common in patients with heart disease. About one-third of patients with congestive heart failure (CHF) and 10% to 20% of those with coronary heart disease (CHD) are anemic. Anemia in patients with CHF and CHD is associated with poorer outcomes, including an increased risk of hospitalization, decreased exercise capacity, and poor quality of life. Despite the association with poorer outcomes, it is unclear whether treating anemia or iron deficiency will improve outcomes. Anemia treatment strategies in heart failure and CHD patients include erythropoiesis-stimulating agents (ESAs work to stimulate bone marrow to produce red blood cells) and red blood cell transfusions. Iron replacement in iron deficient patients with or without anemia also has been investigated.
Investigators at the VA Evidence-based Synthesis Program in Portland, OR conducted a review of the literature from 1947 through November 2010 to evaluate the balance of benefit and harms of treatments for anemia among patients with heart disease, in particular, chronic heart failure or coronary heart disease (i.e., acute coronary syndrome, post-acute coronary syndrome, history of myocardial infarction, or angina). After screening more than 2,400 articles, 49 studies (28 of which were randomized controlled trials) were reviewed in detail to answer the following three key questions:
Suggestions for Future Research
This report is a product of the HSR&D Evidence-based Synthesis Program (ESP), which was established to provide timely and accurate synthesis of targeted healthcare topics of particular importance to VA managers and policymakers -- and to disseminate these reports throughout VA.
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This Management eBrief is a product of the HSR&D Evidence Synthesis Program (ESP). ESP is currently soliciting review topics from the broader VA community. Nominations will be accepted electronically using the online Topic Submission Form. If your topic is selected for a synthesis, you will be contacted by an ESP Center to refine the questions and determine a timeline for the report.
This Management e-Brief is provided to inform you about recent HSR&D findings that may be of interest. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs. If you have any questions or comments about this Brief, please email CIDER. The Center for Information Dissemination and Education Resources (CIDER) is a VA HSR&D Resource Center charged with disseminating important HSR&D findings and information to policy makers, managers, clinicians, and researchers working to improve the health and care of Veterans.
This report is a product of the HSR&D Evidence-Based Synthesis Program (ESP), which was established to provide timely and accurate synthesis of targeted healthcare topics of particular importance to VA managers and policymakers - and to disseminate these reports throughout VA.
See the full reports online.