The Role of Treatment for Anemia as a Therapeutic Target in the Management of Chronic Heart Failure: Insights After RED-HF.

OPINION STATEMENT: Anemia is common in patients with heart failure (HF) and appears to be closely linked with HF prognosis. A variety of mechanisms have been implicated in the association between anemia and HF, and treatment of anemia as a therapeutic target in HF patients is gaining increased attention. Recently large randomized controlled trials of erythropoietin-stimulating agents (ESA) and intravenous iron supplementation therapy have been completed and shed light on treatment of anemia in HF patients. ESA therapy did not show improvement in clinical outcomes, but intravenous iron supplementation may be of benefit in improving HF symptoms. Anemia has been commonly reported in patients with chronic heart failure (HF) and its prevalence appears to be closely linked with the severity of HF. Furthermore, the presence of anemia in patients with HF has been consistently associated with poor prognosis. Despite an increasing number of studies evaluating the relationship between HF and anemia, the answer to whether anemia is simply a marker or a mediator of poor prognosis in HF patients remains uncertain. One approach to this pivotal question has been to investigate treatment for anemia as a therapeutic target in HF.