Anemia is an adverse prognostic marker in both cardiac diseases and infectious diseases.
In patients with bacterial endocarditis (IE), anemia has a prevalence of 55-80%. In a
sub-study to our POET I trial (RCT with 400 patients with IE, published in NEJM 2019),
preliminary data show a 5-fold increased risk of death within 6 months and 2-fold
increased risk after 3 years, in non-surgically treated patients with hemoglobin
<6.2mmol/L, compared to patients with no or mild anemia. Intensified treatment of anemia
through e.g. intravenous iron infusions, in combination with erythrocyte stimulating
agents or new treatments for anemia of inflammation, such as IL-6 inhibitors, could
possibly improve outcome for patients with IE.
This study - ANIE - is a prospective study, aiming at further deep-characterizing of
anemia in patients with IE, and associated outcomes. Degree of anemia of inflammation
(AI) and iron-deficiency anemia during hospitalization and time to recovery will be
assessed. Blood samples from 100 patients with IE will be collected during
hospitalization and 3 months after discharge, i.e. also during expected recovery. Samples
will be analyzed for standard markers of anemia and inflammation, as well as novel
biomarkers for AI, such as IL-6, soluble transferrin receptor, erythroferrone and
hepcidin. The sample size calculation is based on the assumption that the prevalence of
AI is 50%, with a confidence interval of 95% and a margin of error of <10%. Comparisons
will be made to patients with other infections and patients with pure inflammation (TAVI
and TEVAR patients) and healthy blood donors.
ANIE is expected to give us an unprecedented insight into disease processes, stages and
possible therapeutic targets for anemia in patients with IE.
The results will serve for designing the clinical trial of novel interventions to treat
anemia in patients with IE, as a novel means to improve the outcome and reduce the high
mortality in these patients.
Anemia is an adverse prognostic marker in both cardiac diseases and infectious diseases.
In patients with bacterial endocarditis (IE), anemia has a prevalence of 55-80%. In a
sub-study to our POET I trial (RCT with 400 patients with IE, published in NEJM 2019),
preliminary data show a 5-fold increased risk of death within 6 months and 2-fold
increased risk after 3 years, in non-surgically treated patients with hemoglobin
<6.2mmol/L, compared to patients with no or mild anemia. Intensified treatment of anemia
through e.g. intravenous iron infusions, in combination with erythrocyte stimulating
agents or new treatments for anemia of inflammation, such as IL-6 inhibitors, could
possibly improve outcome for patients with IE.
This study - ANIE - is a prospective study, aiming at further deep-characterizing of
anemia in patients with IE, and associated outcomes. Degree of anemia of inflammation
(AI) and iron-deficiency anemia during hospitalization and time to recovery will be
assessed. Blood samples from 100 patients with IE will be collected during
hospitalization and 3 months after discharge, i.e. also during expected recovery. Samples
will be analyzed for standard markers of anemia and inflammation, as well as novel
biomarkers for AI, such as IL-6, soluble transferrin receptor, erythroferrone and
hepcidin. The sample size calculation is based on the assumption that the prevalence of
AI is 50%, with a confidence interval of 95% and a margin of error of <10%. Comparisons
will be made to patients with other infections and patients with pure inflammation (TAVI
and TEVAR patients) and healthy blood donors.
ANIE is expected to give us an unprecedented insight into disease processes, stages and
possible therapeutic targets for anemia in patients with IE.
The results will serve for designing the clinical trial of novel interventions to treat
anemia in patients with IE, as a novel means to improve the outcome and reduce the high
mortality in these patients.
