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Perspectives

Anaemia in heart failure: the clinical perspective

Christopher S Hayward

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Abstract

Iron supplementation and erythropoietin replacement improve symptoms but have not been shown to reduce hospitalisation or mortality.

Key Points

  • Anaemia occurs in more than 10% of patients with heart failure.
  • Anaemia is associated with decreased survival and increased hospitalisation in patients with heart failure.
  • Anaemia is multifactorial, including not only iron deficiency but also bone marrow paresis and haemodilution.
  • Alternative causes for anaemia should be sought and corrected in patients with heart failure.
  • Iron replacement improves symptoms in anaemic or non-anaemic patients with heart failure – even without a change in haemoglobin concentration.
  • Correction of anaemia by erythropoiesis stimulants is associated with improved symptoms in heart failure.

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