The prognostic value of endogenous erythropoietin in chronic heart failure

Comorbidity including chronic kidney disease (CKD) and anemia worsens the prognosis in patients with chronic heart failure (CHF). In patients chronic cardiorenal syndrome (CRS), hypoxia caused by CHF affects the formation of endogenous erythropoietin (eEPO). However, the predictive value of eEPO in patients with CHF, depending on CKD, have not been insufficiently studied. The aim of this study was to investigate the prognostic value of eEPO in patients with CHF. Materials and methods. 80 patients with CHF (48 women, mean age 70.1±9.7 years) were examined. CHF was carried out according to the recommendations for the diagnosis and treatment of CHF of the Russian Society of Heart Failure Specialists (OSSN) and the Russian Society of Cardiology (RKO, Clinical Guidelines. Chronic heart failure (CHF), 2016). CKD was diagnosed and classified according to the KDIGO guidelines (2012). Serum levels of eEPO, hypoxia-inducible factor-1 (HIF-1), N-terminal propeptide of type B natriuretic hormone (NT-proBNP) were assessed. The follow-up period was 12 months, the primary endpoint was death. Results. CKD was diagnosed in 49 (61.3%) patients with CHF. The eEPO level was significantly higher in the group of deceased patients with CHF than in the survivors - 16.92 (ICR 5.43; 64.57) and 5.76 (IQR 1.71; 8.85) mIU/ml, р=0.0004, as well as the level of NT-proBNP - 1126.3 (IQR 551.8; 2750.0) and 162.1 (IQR 135.0; 930.7) pg/ml, р<0.0001 and HIF-1 - 0.08 (IQR 0.06; 0.11) and 0.05 (IQR 0.04; 0.07) ng/ml, р=0.01. Multivariate regression analysis showed an independent relationship between the eEPO level and patient survival (R=0.37, ß=0.32, р=0.007). Conclusions. The level of eEPO in patients with chronic heart failure has an independent and closer relationship with the mortality of patients than the traditional marker of the severity and prognosis of CHF - NT-proBNP.

хроническая сердечная недостаточность, хроническая болезнь почек, эритропоэтин, фактор, индуцируемый гипоксией-1, хронический кардиоренальный синдром, chronic heart failure, chronic kidney disease, erythropoietin, hypoxia-1 inducible factor, chronic cardiorenal syndrome

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