Heart failure & cardiomyopathiesMeta-analysis
Erythropoiesis-stimulating agents to reduce heart failure hospitalization: a systematic review and meta-analysis
- Systematic review and meta-analysis of randomised trials
- pre-registered
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 adults · 14 RCTs
- Comparison
- Erythropoiesis-stimulating agents (ESAs) vs placebo or no treatment
Pooled result
First chronic heart failure (CHF) hospitalization
Peto OR
0.93
95% CI 0.78–1.10
P = 0.37
ESAs vs Control
Peto OR 0.93 (95% CI 0.78–1.10); P = 0.37
As reported in the abstract
Further pooled results
| Outcome | ESAs | Control | IRR (95% CI) | P value | |
|---|---|---|---|---|---|
| Total CHF hospitalization · I2 = 0% | 622 events/2698 person-years | 761/2914 person-years | 0.81 (0.73–0.90) | P < 0.001 | |
| 0.512Incidence rate ratio (log scale) |
| Outcome | MD (g/dL) (95% CI) | P value | |
|---|---|---|---|
| Haemoglobin | 1.6 (1.6–1.7) | P < 0.001 | |
| −1012Difference, g/dL (linear scale) |
| Outcome | MD (metres) (95% CI) | P value | |
|---|---|---|---|
| Exercise tolerance | 69 (17–122) | P = 0.009 | |
| −50050100150Difference, metres (linear scale) |
| Outcome | MD (class) (95% CI) | P value | |
|---|---|---|---|
| NYHA class on follow-up | −0.73 (−1.11 to −0.36) | P < 0.001 | |
| −1.5−1−0.500.5Difference, class (linear scale) |
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
Summarised from the published abstract; every number is checked against it