Department of Cardiovascular Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0329, Kanagawa, Japan.
Medicina (Kaunas). 2024 Jan 1;60(1):84. doi: 10.3390/medicina60010084.
Hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitors have been approved as an oral drug for treating anemia in chronic kidney disease (CKD). However, the clinical effect of HIF-PH inhibitors in patients with heart failure (HF) is unclear. Thus, this study investigated the effect of HIF-PH inhibitors in patients with HF and CKD. Thirteen patients with HF complicated by renal anemia who were started on vadadustat were enrolled. Clinical parameters were compared before and 1 month after vadadustat was started. The mean left ventricular ejection fraction was 49.8 ± 13.9%, and the mean estimated glomerular filtration rate was 29.4 ± 10.6 mL/min/1.73 m. The hemoglobin level was significantly increased (9.7 ± 1.3 mg/dL vs. 11.3 ± 1.3 mg/dL, < 0.001), and the N-terminal prohormone of B-type natriuretic peptide was significantly decreased after the introduction of vadadustat [4357 (2651-15182) pg/mL vs. 2367 (1719-9347) pg/mL, = 0.002]. Furthermore, the number of patients with New York Heart Association functional class ≥ 3 was also decreased after the introduction of vadadustat [8 (61.5%) vs. 1 (7.7%), = 0.008]. No thromboembolic adverse events or new tumors were observed in any patient during the study period. The introduction of vadadustat in patients with HF complicated by renal anemia led to improvements in anemia and symptoms of HF.
缺氧诱导因子脯氨酰羟化酶（HIF-PH）抑制剂已被批准作为治疗慢性肾脏病（CKD）贫血的口服药物。然而，HIF-PH 抑制剂在心力衰竭（HF）患者中的临床效果尚不清楚。因此，本研究探讨了 HIF-PH 抑制剂在 HF 和 CKD 患者中的作用。
纳入了 13 例开始服用vadadustat 的 HF 合并肾性贫血患者。比较了vadadustat 开始使用前后的临床参数。
平均左心室射血分数为 49.8 ± 13.9%，平均估算肾小球滤过率为 29.4 ± 10.6 mL/min/1.73 m。血红蛋白水平显著升高（9.7 ± 1.3 mg/dL 比 11.3 ± 1.3 mg/dL， < 0.001），引入vadadustat 后 N 端脑利钠肽前体显著降低[4357（2651-15182）pg/mL 比 2367（1719-9347）pg/mL， = 0.002]。此外，引入vadadustat 后，纽约心脏协会功能分类≥3 的患者人数也减少[8（61.5%）比 1（7.7%）， = 0.008]。在研究期间，任何患者均未观察到血栓栓塞不良事件或新发肿瘤。
在 HF 合并肾性贫血患者中引入vadadustat 可改善贫血和 HF 症状。
