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La eritropoyetina endógena y el resultado en la insuficiencia cardíaca
Anne M S Belonje1, Adriaan A Voors, Peter van der Meer
1Departments of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
Circulation
|January 6, 2010
Resumen
Los niveles elevados de eritropoyetina en pacientes con insuficiencia cardíaca (IC) predicen un mayor riesgo de mortalidad. Los niveles persistentemente altos y una mayor proporción de eritropoyetina observada/predecida en pacientes anémicos indican un peor pronóstico.
Área de la Ciencia:
- Cardiología Cardiología.
- Endocrinología Endocrinología.
- Medicina interna es la medicina interna de las enfermedades.
Sus antecedentes:
- El aumento de la eritropoyetina endógena es común en la insuficiencia cardíaca (IC).
- Estudios previos sugieren que los niveles de eritropoyetina se correlacionan con el pronóstico de HF.
- Esta investigación investiga el significado clínico y pronóstico de la eritropoyetina en una gran cohorte de HF.
Objetivo del estudio:
- Para evaluar el valor pronóstico de los niveles de eritropoyetina en pacientes con insuficiencia cardíaca.
- Para examinar la relación entre los niveles de eritropoietina y hemoglobina.
- Para determinar el poder predictivo de la eritropoietina persistentemente elevada y la relación observada/predecida para la mortalidad.
Principales métodos:
- Los niveles de eritropoyetina endógena medidos en el momento del alta y después de 6 meses en pacientes hospitalizados con HF.
- Calculó la relación eritropoyetina observada/predecida en pacientes anémicos.
- Se utilizó un análisis multivariado de regresión de Cox para identificar predictores de mortalidad.
Principales resultados:
- Los niveles basales más altos de eritropoietina predijeron de forma independiente un aumento de la mortalidad a los 18 meses (HR 2.06).
- Los niveles persistentemente elevados de eritropoyetina (por encima de la mediana en ambos momentos) se relacionaron con un mayor riesgo de mortalidad (HR 2.24).
- Una mayor proporción de eritropoyetina observada / predicha en pacientes anémicos se asoció con un aumento de la mortalidad (HR 3.52).
Conclusiones:
- Los niveles de eritropoietina son predictores significativos de la mortalidad en la insuficiencia cardíaca.
- Los niveles persistentemente elevados de eritropoyetina tienen un valor pronóstico independiente.
- Una mayor proporción de eritropoyetina observada/predecida en pacientes anémicos con HF puede indicar un mayor riesgo de mortalidad.
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