Cardiology Letters 2017, 26(1):52-54

Anemia and endothelin receptor antagonists - a real risk?

Kováčová M, Luknár M, Danková M, Lesný P, Šimovičová V, Gonçalvesová E

Národný ústav srdcových a cievnych chorôb, a.s. v Bratislave, Slo­ venská republika

Endothelin receptor antagonists (ERAs) are linked to anemia development and periodical blood count checkups are recommended with ERA treatment. Pathobiology, characteristics, as well as clinical significance of anemia associated with ERA use, have not been satisfactorily clarified and real-life data are scarce. The aim of our study was to describe the frequency and some other characteristics of anemia and red blood count in a cohort of patients with pulmonary arterial hypertension (PAH) treated by ERAs. Eighty-four consecutive patients (57 women) with PAH treated with ERAs more than four months in a single centre from 2005 to 2016 were included in the retrospective analysis. ERA treatment was associated with a slight, statistically-significant, decrease in hemoglobin levels (145 ± 23,0 vs. 138 ± 22.9 g/l, p<0,001). The prevalence of anemia in patients treated by ERA was not increased in comparison with baseline (19% during treatment vs. 18% at baseline). One third of patients showed an Hb drop of >10 g/L. We expect that a slight decrease in hemoglobin levels in patients with PAH may have a negative impact on exercise tolerance and "eliminating" the positive effect of ERA. Caution is warranted in patients with pre-existing anemia as it may further deteriorate with ERA treatment.

Keywords: endothelin receptor antagonists; anemia; pulmonary arterial hypertension

Published: January 1, 2017  Show citation