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Cardiovascular Research 2003 59(3):538-548; doi:10.1016/S0008-6363(03)00468-1
© 2003 by European Society of Cardiology
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Copyright © 2003, European Society of Cardiology

The cardiovascular effects of erythropoietin

Kyle J Smith, Anthony J Bleyer, William C Little and David C Sane*

Sections of Cardiology and Nephrology, Department of Internal Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1045, USA

dsane{at}wfubmc.edu

* Corresponding author. Tel.: +1-336-716-7533; fax: +1-336-716-9188.

Erythropoietin is a hypoxia-induced hormone that is essential for normal erythropoiesis. The production of recombinant human erythropoietin (rHuEpo) has revolutionized the treatment of anemia associated with chronic renal failure and chemotherapy, and has been used as prophylaxis to prevent anemia after surgery. The erythropoietin receptor is widely distributed in the cardiovascular system, including endothelial cells, smooth muscle cells and cardiomyocytes. Epo has potentially beneficial effects on the endothelium including anti-apoptotic, mitogenic and angiogenic activities. On the other hand, some reports suggest that rHuEpo may have pro-thrombotic or platelet-activating effects. Hypertension develops in 20–30% of renal patients treated with rHuEpo. Many patients with heart failure have anemia. Despite some potential adverse effects, early studies in heart failure patients with anemia suggest that rHuEpo therapy is safe and effective in reducing left ventricular hypertrophy, enhancing exercise performance and increasing ejection fraction. Further studies are warranted to define the role of rHuEpo in chronic heart failure and other cardiovascular settings.

KEYWORDS Angiogenesis; Endothelial function; Platelets; Renal function; Thrombosis/embolism


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