Serum erythropoietin in heart failure patients treated with ACE‐inhibitors or AT1 antagonists

Abstract

Background Erythropoietin (Epo), a growth factor produced by the kidney, is important in heart failure patients to promote oxygen delivery to tissues. Seventy‐two chronic heart failure (CHF) patients at our outpatient clinic were subjected to morning serum Epo‐level measurements and classified according to NYHA criteria. Results Forty‐eight patients of classes III and IV had a significantly elevated serum Epo‐level of 42.9±40.3 mIU/ml (mean±1 S.D.) when compared to the mean level of 24 patients of classes I and II who had a normal range mean value of 13.4±6.2 mIU/ml (P1 antagonists) (levels: 33.3±35.6 mIU/ml and 43.6±38.1 mIU/ml). This trend did not, however, reach statistical significance (P=0.36). Conclusion We suggest that a desirable Epo increase in class III and IV CHF patients could be achieved by either recombinant human Epo administration or, possibly, by appropriate selection of the concomitant medical therapy. A large prospective study shall investigate the possible advantage of AT₁ antagonists over ACE‐inhibitors with regard to Epo effect.