Clinical Scorecard: Association of Heart Failure Hospitalization Risk with Hypoxia-Inducible Factor Prolyl Hydroxylase Inhibitors Compared to Erythropoiesis-Stimulating Agents: A Nationwide Claims Analysis

At a Glance

Key Highlights

• HIF-PHIs associated with increased risk of heart failure hospitalization compared to ESAs.
• Daprodustat showed a hazard ratio of 1.22 for first heart failure hospitalization.
• Higher risk observed in patients with a history of heart failure (HR 1.37).
• Total heart failure hospitalization events increased with daprodustat (HR 1.46).
• Limited evidence from routine practice regarding cardiovascular safety of HIF-PHIs.

Guideline-Based Recommendations

Diagnosis

• Heart failure diagnosis requires at least one recorded diagnosis code (ICD-10: I110 or I50).

Management

• HIF-PHIs and ESAs are used for managing renal anemia in CKD patients.

Monitoring & Follow-up

• Monitor for heart failure hospitalization and cardiovascular safety in patients receiving HIF-PHIs.

Risks

• Potential risks include thromboembolic events, fluid retention, and worsening heart failure.

Patient & Prescribing Data

Adults (≥ 18 years) with heart failure and chronic kidney disease.

HIF-PHIs may pose a higher risk of heart failure hospitalization compared to ESAs.

Clinical Best Practices

• Consider cardiovascular safety when prescribing HIF-PHIs in high-risk CKD patients.
• Utilize diuretics as needed in managing heart failure symptoms.

Related Resources & Content

• ASCEND-ND Trial
• ASCEND-D Trial