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Randomized double-blind trial of darbepoetin alfa in patients with symptomatic heart failure and anemia.

Publication ,  Journal Article
Ghali, JK; Anand, IS; Abraham, WT; Fonarow, GC; Greenberg, B; Krum, H; Massie, BM; Wasserman, SM; Trotman, M-L; Sun, Y; Knusel, B ...
Published in: Circulation
January 29, 2008

BACKGROUND: Substantial evidence suggests that anemia is an independent risk factor for worse outcomes in patients with heart failure (HF). The Study of Anemia in Heart Failure Trial (STAMINA-HeFT) is the largest multicenter, randomized, double-blind, placebo-controlled trial to date evaluating the effect of treating anemia in HF. METHODS AND RESULTS: Patients (N=319) with symptomatic HF, left ventricular ejection fraction < or = 40%, and hemoglobin > or = 9.0 g/dL and < or = 12.5 g/dL were randomized (double-blind) to placebo (N=157) or darbepoetin alfa (N=162) subcutaneously every 2 weeks for 1 year (target hemoglobin, 14.0+/-1.0 g/dL). The primary end point was change from baseline to week 27 in treadmill exercise time. Secondary end points were change from baseline in New York Heart Association class and quality of life at week 27. An additional prespecified efficacy analysis included the time to death by any cause or first HF-related hospitalization by 1 year. At baseline, the median (interquartile range) hemoglobin was 11.4 (10.9, 12.0) g/dL. At week 27, darbepoetin alfa treatment increased median (interquartile range) hemoglobin by 1.8 (1.1, 2.5) g/dL (placebo, 0.3 [-0.2, 1.0] g/dL; P<0.001). Of the patients treated with darbepoetin alfa, 85% achieved 2 consecutive hemoglobin levels of 14.0+/-1.0 g/dL during the study and experienced a hemoglobin increase of > or = 1.0 g/dL from baseline. By intent-to-treat analysis, darbepoetin alfa treatment did not significantly improve exercise duration, New York Heart Association class, or quality of life score compared with placebo. A nonsignificant trend was observed toward a lower risk of all-cause mortality or first HF hospitalization in darbepoetin alfa-treated patients compared with placebo (hazard ratio, 0.68; 95% CI, 0.43, 1.08; P=0.10). Occurrences of adverse events were similar in both treatment groups. CONCLUSIONS: In this study of patients with symptomatic HF and anemia, treatment with darbepoetin alfa was not associated with significant clinical benefits. Darbepoetin alfa treatment was well tolerated and effectively raised hemoglobin. A trend of lower risk of morbidity and mortality was observed.

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Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

January 29, 2008

Volume

117

Issue

4

Start / End Page

526 / 535

Location

United States

Related Subject Headings

  • Survival Rate
  • Stroke Volume
  • Quality of Life
  • Middle Aged
  • Male
  • Humans
  • Hemoglobins
  • Heart Failure
  • Female
  • Exercise Tolerance
 

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Ghali, J. K., Anand, I. S., Abraham, W. T., Fonarow, G. C., Greenberg, B., Krum, H., … Study of Anemia in Heart Failure Trial (STAMINA-HeFT) Group. (2008). Randomized double-blind trial of darbepoetin alfa in patients with symptomatic heart failure and anemia. Circulation, 117(4), 526–535. https://doi.org/10.1161/CIRCULATIONAHA.107.698514
Ghali, Jalal K., Inder S. Anand, William T. Abraham, Gregg C. Fonarow, Barry Greenberg, Henry Krum, Barry M. Massie, et al. “Randomized double-blind trial of darbepoetin alfa in patients with symptomatic heart failure and anemia.Circulation 117, no. 4 (January 29, 2008): 526–35. https://doi.org/10.1161/CIRCULATIONAHA.107.698514.
Ghali JK, Anand IS, Abraham WT, Fonarow GC, Greenberg B, Krum H, et al. Randomized double-blind trial of darbepoetin alfa in patients with symptomatic heart failure and anemia. Circulation. 2008 Jan 29;117(4):526–35.
Ghali, Jalal K., et al. “Randomized double-blind trial of darbepoetin alfa in patients with symptomatic heart failure and anemia.Circulation, vol. 117, no. 4, Jan. 2008, pp. 526–35. Pubmed, doi:10.1161/CIRCULATIONAHA.107.698514.
Ghali JK, Anand IS, Abraham WT, Fonarow GC, Greenberg B, Krum H, Massie BM, Wasserman SM, Trotman M-L, Sun Y, Knusel B, Armstrong P, Study of Anemia in Heart Failure Trial (STAMINA-HeFT) Group. Randomized double-blind trial of darbepoetin alfa in patients with symptomatic heart failure and anemia. Circulation. 2008 Jan 29;117(4):526–535.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

January 29, 2008

Volume

117

Issue

4

Start / End Page

526 / 535

Location

United States

Related Subject Headings

  • Survival Rate
  • Stroke Volume
  • Quality of Life
  • Middle Aged
  • Male
  • Humans
  • Hemoglobins
  • Heart Failure
  • Female
  • Exercise Tolerance