Objectives This study aimed to investigate the prognostic importance of plasma erythropoietin(EPO) levels in chronic heart failure (CHF) patients. Background Anemia is common and is associated with an impaired survival in patients with CH F. Erythropoietin is a hematopoietic growth factor, upregulated in anemic condit ions. Little is known about the pathophysiology of anemia in CHF and the prognos tic importance of plasma EPO levels in CHF patients. Methods In 74 patients with CHF(age, 61±2 years; left ventricular ejection fraction,0.31±0.01; peak oxyge n consumption, 19.1±0.6 >) and in 15 control patients, hemoglobin lev els and plasma concentrations of EPO and brain natriuretic peptide were measured . Results During a mean follow-up of 3.0 years (range, 2.3 to 5.3 years), 22 pa tients (30%) died. Anemia was present in 24%of the patients. Multivariate anal ysis showed that plasma EPO(p =0.026) and hemoglobin levels (p=0.005) were indep endent predictors of survival in this CHF population. We observed only a mild in verse correlation between the logarithm of EPO and hemoglobin levels (r2=0.08, p =0.02) in CHF patients,whereas the control group showed a clear significant inve rse correlation (r2=0.44, p=0.007). Conclusions Elevated plasma EPO levels are a ssociated with an impaired prognosis independent of hemoglobin levels and other established markers of CHF severity. Furthermore, in the CHF patients, EPO level s poorly correlate with the hemoglobin levels, in contrast with the control grou p.
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