A.M. Vasylenko, S.O. Sheiko Correction of anemia syndrome in elderly patients with chronic heart failure.

The aim of the investigation was: to increase efficacy of treatment of anemia syndrome (AS) in elderly patients with chronic heart failure (CHF) by means of defining and correction of key pathogenetic mechanisms of anemia development. 209 patients of elderly age with CHF and AS manifestations were examined. The factors of AS development in elderly patients with CHF are the presence of iron deficiency, early decrease of glomerular
filtration rate (GFR) and disturbance of erythropoietin secretion (ERP). Patients with CHF II–III FC with the level of hemoglobin (Hb) 120–110 g/l, decreased level of serum iron, increased level of ferritin (Fe) and the normal level of ERP with the aim of AS correction should be administered iron medications. With concentration of Hb < than 110g/l, decreased level of serum iron, increase of Fe level and decrease of ERP, treatment of AS in elderly patients should include iron medications and epoetin-beta. In 24.5 % patients an increased level of ERP was defined. This phenomenon should be regarded as erythropoietin-resistance. With the aim to overcome
syndrome of erythropoietin-resistance and correction of AS in a given category of patients it is necessary to administer epoetin-beta according to defined procedure. Prophylaxis of AS in elderly patients with CHF should
be started with early treatment of CHF according to the international standards. Instead of inhibitors of angiotensin converting enzyme it is rational to use sartans (candesartan, valsartan). In case of CHF and AS progressing aspirin should not be administered.

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