Department of Cardiovascular Medicine, Tosei General Hospital, Seto, Japan.
Department of Advanced Cardiovascular Therapeutics, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, 466-8550, Japan.
BMC Res Notes. 2024 Mar 1;17(1):60. doi: 10.1186/s13104-024-06726-7.
Hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitors are a new class of anti-anemia agents. We retrospectively evaluated the safety and efficacy of HIF-PH inhibitors in patients with heart failure (HF) complicated by anemia associated with chronic kidney disase. HIF-PH inhibitor treatment was initiated in 32 patients with chronic HF complicated by renal anemia and were followed up for 3 months.
Hematocrit and hemoglobin levels markedly improved 3 months after HIF-PH inhibitor treatment. However, levels of NT-proBNP, which is an indicator of HF, did not decrease considerably. Based on the rate of change in NT-proBNP, we divided the patients into "responder" and "non-responder" groups. The results showed that considerably more patients had a ferritin level of less than 100 ng/mL in the non-responder group at baseline. There were substantially more patients with TSAT of less than 20% in the non-responder group at 1 month after HIF-PH inhibitor treatment. The cut-off values to maximize the predictive power of ferritin level at baseline and TSAT value at 1 month after treatment were 41.8 ng/ml and 20.75. HIF-PH inhibitor treatment can be expected to be effective for improving both anemia and HF if ferritin≥41.8 ng/ml at baseline or TSAT≥20.75 at 1 month after treatment.
缺氧诱导因子脯氨酰羟化酶（HIF-PH）抑制剂是一类新型的抗贫血药物。我们回顾性评估了 HIF-PH 抑制剂在伴有慢性肾脏病贫血的心力衰竭（HF）患者中的安全性和疗效。在 32 例伴有慢性 HF 和肾性贫血的患者中开始使用 HIF-PH 抑制剂治疗，并随访 3 个月。
HIF-PH 抑制剂治疗 3 个月后，红细胞比容和血红蛋白水平显著改善。然而，HF 的指标 NT-proBNP 水平并没有明显降低。根据 NT-proBNP 的变化率，我们将患者分为“应答者”和“非应答者”两组。结果显示，基线时非应答组的铁蛋白水平<100ng/ml 的患者明显更多。在 HIF-PH 抑制剂治疗 1 个月后，非应答组的转铁蛋白饱和度（TSAT）<20%的患者明显更多。铁蛋白水平在基线时和治疗后 1 个月时的截断值分别为 41.8ng/ml 和 20.75，以最大限度地提高预测效力。如果基线时铁蛋白≥41.8ng/ml 或治疗后 1 个月时 TSAT≥20.75，则 HIF-PH 抑制剂治疗有望有效改善贫血和 HF。
