Heart failure & cardiomyopathies

Erythropoiesis-stimulating agents to reduce heart failure hospitalization: a systematic review and meta-analysis

Eur J Heart FailPublished Systematic review and meta-analysis of randomised trials

Pooled result · First CHF hospitalizationResult — go to the resultPeto OR 0.93 95% CI 0.78–1.10

Authors' conclusion

ESA treatment in patients with CHF and mild anaemia can reduce recurrent CHF hospitalization and improve functional capacity, without any impact on adverse events.

Study context

Population
Adults with chronic HF and anaemia
Participants
3,128 adults14 RCTs
Comparison
Erythropoiesis-stimulating agents (ESAs) vs placebo or no treatment
Outcome
First chronic heart failure (CHF) hospitalization
Methodological detailspre-registered
  • Pre-registered

Pooled result

As reported in the abstract

Peto OR

0.93

95% CI 0.78–1.10

P = 0.37

ESAsvs Control
Peto OR 0.93 (95% CI 0.78–1.10); P = 0.37

Further pooled results

OutcomeESAsControlIRR (95% CI)P value
Total CHF hospitalizationI2 = 0%622 events/2698 person-years761/2914 person-years0.81 (0.73–0.90)P < 0.001
OutcomeMD (g/dL) (95% CI)P value
Haemoglobin1.6 (1.6–1.7)P < 0.001
OutcomeMD (metres) (95% CI)P value
Exercise tolerance69 (17–122)P = 0.009
OutcomeMD (class) (95% CI)P value
NYHA class on follow-up−0.73 (−1.11 to −0.36)P < 0.001

All-cause mortality

No significant difference between treatment groups (OR 1.01, 95% CI 0.86-1.18; I2 = 35%)
P = 0.88

Safety

Incident adverse events

No significant differences between treatment groups

Original publication

Erythropoiesis-stimulating agents to reduce heart failure hospitalization: a systematic review and meta-analysis. Eur J Heart Fail. Published 8 January 2026. doi:10.1093/ejhf/xuaf012

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