Anemia and heart failure

Purpose of review The earlier enthusiasm for raising hemoglobin in heart failure has been followed by skepticism and concern of potential harm from using erythropoiesis-stimulating agents (ESAs). Recent findings Several recent studies have confirmed the high prevalence and prognostic role of anemia and have shown encouraging signals of the safety of using ESAs in heart failure and potential benefit that may be related to nonhematopoietic effects of ESAs. In addition, recent studies have also suggested a potential beneficial role of iron replacement in heart failure. Summary Despite the encouraging findings of these preliminary studies, the future role of ESAs and iron replacement will be determined by ongoing randomized placebo-controlled studies.