Copyright ©The Author(s) 2023.
World J Cardiol. May 26, 2023; 15(5): 273-283
Published online May 26, 2023. doi: 10.4330/wjc.v15.i5.273
Table 1 Summary of included studies
Ref.Study designNo. of PatientsEPO dosage and treatment durationAverage Hb level (g/dL)
EPO's effect on
Other findings
Before EPO therapy
After EPO therapy
Without EPO treatment
Hb level
Major CV event
Hospitalization rate
Jackevicius et al[12], 2015 Retrospective cohort2058N/AN/A10.511.1Inverse relationship between EPO therapy and Hb levels N/AN/AThe strongest predictors of EPO use include iron supplementation, markers of declining renal function, and patients concurrently taking hydralazine, nitrates, ARBs, and/or aspirin
Eisenga et al[13], 2019 Open-label, prospective, randomized trial56N/A11.713.211.8Increased Hb levelsIncreased cFGFR23 and iFGFR23, increased risk of CV events and mortalityN/AN/A
McMurray et al[14], 2011 Randomized trial3847N/AN/AN/AN/AN/APatients with CKD and anemia have an 11.2% higher risk for a major CV event. History of CHF was the highest-ranked predictor of future CV events, followed by age (hazard increase by 74% and 27%, respectively)N/AN/A
Fazlibegović et al[15], 2006 Prospective cohort902000 to 6000 international units (I.U.) for 1-3 times per week, depending on the Hb level8.710.1N/AIncreased Hb levelsImproved functional ability of the myocardium, LV function, and quality of lifeN/AThe average NYHA class before treatment with EPO was class II, with a range of I-IV; after treatment, the average class was I, with a range of I-II
Palazzuoli et al[11], 2007 A randomized, double-blind controlled study516000 I.U. twice weekly10.411.210.6Increased Hb levelsImproved LV systolic function, LV remodeling, NYHA class, BNP levels, and quality of life compared to control groupN/AN/A
Jie et al[16], 2011 Open-label randomized trial65N/A7.58.46.9Increased Hb levels with long term useN/AN/AReduced CD34+ KRD-EPC levels, which was associated with decreased vascular regenerative potential
Jackevicius et al[17], 2014 Retrospective cohort study205810.5:

11.1Increased Hb levelsIncreased risk of major CV and acute coronary syndrome eventsIncreased risk of an all-cause hospitalization rateEPO use increases the risk of mortality
Jie et al[18], 2012 Randomized trial3050 I.U./kg once weekly11.812.3N/AIncreased Hb levelsModest alteration in monocyte transcriptomes, indicating imprints of inflammation and oxidative stress. The increase in oxidative stress, in turn, increased the risk of CV eventsN/AVariable response in gene expression. Unable to conclude whether EPO improved hematopoietic effects in CRS patients with such gene mutations
Emans et al[19], 2013 Open-label prospective randomized trial6250 I.U./kg once weekly

13.711.8Increased Hb levelsN/AN/AElevated serum NGAL is inversely correlated with baseline EPO levels, independent of renal function. Low-dose EPO treatment caused a moderate decrease in serum NGAL levels, therefore reflecting potential improvement in renal tubular damage