Anemia is common in patients with congestive heart failure and coronary heart disease with co-morbidities up to 30%. After reviewing published studies on anemia from the past 65 years, the ACP strongly discouraged the use of erythropoiesis-stimulating agents to stimulate the production of new red blood cells in patients with mild to moderate anemia and heart disease. Erythropoiesis-stimulating agent treatment was associated with an increased risk of venous thrombosis. In 2012, the AABB did not recommend a liberal or restrictive transfusion strategy for patients with acute coronary syndrome due to lack of evidence. The ACP, however, recommends a restrictive transfusion strategy at hemoglobin levels lower than 7-8 grams per deciliter for hospitalized patients with coronary heart disease, although the evidence in the literature is not strong. Current evidence for treatment of anemia in heart disease patients with IV iron was inconclusive.
1. Qaseem A, Humphrey LL, Fitterman N, Starkey M, Shekelle P, Clinical Guidelines Committee of the American College of P. Treatment of anemia in patients with heart disease: a clinical practice guideline from the american college of physicians. Ann Intern Med 2013,159:770-779.