Anemia and heart failure: Is there still a role for erythropoiesis-stimulating agents?

A early reports of erythropoiesis-stimulating agents (ESAs) having success correcting anemia in heart failure (HF), the Reduction of Events by Darbepoetin Alfa in Heart Failure (RED-HF) study, a large phase III trial, demonstrated that darbepoetin alfa was not able to improve clinical outcomes in patients with HF who had reduced ejection fraction and mild to moderate anemia, and indeed, it led to an excess of thromboembolic events.[1] In view of those results, recent guidelines do not recommend ESAs for the treatment of anemia in HF patients.[2]