背景:由于两个器官系统之间的重叠,急性心力衰竭患者的心脏和肾脏功能障碍经常共存。心肾综合征(CRS)是由心脏和肾脏中发生的病理以及一个器官功能障碍的后果导致的,反之亦然。
目的:评估CRS患者使用促红细胞生成素(EPO)及其对血红蛋白(Hb)的影响,主要心血管(CV)事件,和住院率。
方法:2022年2月24日,使用PubMed进行了搜索,MEDLINE,和EMBASE,并确定了148篇文章。本系统综述共考虑了9项研究。我们根据国家心脏评估了纳入的文章,肺,和用于对照干预和观察性队列或横断面研究的血液研究所质量评估工具。对所选研究进行了偏倚风险评估,并提取了与我们的审查相关的数据。
结果:对这些研究的系统评价得出的结论是,大多数现有文献表明,EPO可改善基线Hb水平,减少心肌重塑和左心室功能障碍,而不会降低CV死亡率。此外,EPO对CRS患者住院率的影响还需要进一步研究,因为这种关系尚不清楚.未来的研究,如随机对照临床试验和前瞻性队列研究,应加强有关CRS患者EPO治疗潜力的文献。
结论:我们的系统评价表明,EPO治疗可能在控制CRS方面发挥重要作用。该审查强调了EPO在改善基线Hb水平方面的潜在好处,降低重大心血管事件的风险,改善心脏重塑,心肌功能,纽约心脏协会班,和B型利钠肽水平。然而,EPO治疗对住院的影响尚不清楚,需要进一步探索.
BACKGROUND: Heart and kidney dysfunction frequently coexist in patients with acute heart failure due to the overlap between these two organ systems. Cardiorenal syndrome (CRS) results from pathology occurring in the heart and kidneys along with the consequences of dysfunction in one organ contributing to dysfunction in the other and vice versa.
OBJECTIVE: To evaluate the use of erythropoietin (EPO) in patients with CRS and its effects on hemoglobin (Hb), major cardiovascular (CV) events, and hospitalization rates.
METHODS: On February 24, 2022, searches were conducted using PubMed, MEDLINE, and EMBASE, and 148 articles were identified. A total of nine studies were considered in this systematic
review. We assessed the included articles based on the National Heart, Lung, and Blood Institute quality assessment tools for controlled intervention and observational cohort or cross-sectional studies. An assessment of bias risk was conducted on the chosen studies, and data relevant to our
review was extracted.
RESULTS: The systematic
review of these studies concluded that most existing literature indicates that EPO improves baseline Hb levels and decreases myocardial remodeling and left ventricular dysfunction without reducing CV mortality. In addition, the effect of EPO on the hospitalization rate of patients with CRS needs to be further studied since this relationship is unknown. Future studies, such as randomized controlled clinical trials and prospective cohort studies, should be conducted to enhance the literature on the potential of EPO therapy in patients with CRS.
CONCLUSIONS: Our systematic
review suggests that EPO therapy may have a significant role in managing CRS. The
review highlights the potential benefits of EPO in improving baseline Hb levels, reducing the risk of major CV events, improving cardiac remodeling, myocardial function, New York Heart Association class, and B-type natriuretic peptide levels. However, the effect of EPO treatment on hospitalization remains unclear and needs further exploration.