ClinicalTrials.gg
CompletedNCT04840225ANIEUpdated Sep 26, 2025

Anemia in Patients With Endocarditis

An observational study in Anemia and Endocarditis, Bacterial, sponsored by Rigshospitalet, Denmark. Completed at 1 site in Denmark. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-09-26.

Sponsored by Rigshospitalet, Denmark · Observational

Study type
Observational
Model
Case-control
Time perspective
Prospective
Enrollment
209
Ages
18 Years and older
Sex
All
01

Study summary

Prospective study of prevalence and deep charecterization of anemia in patients with endocarditis from diagnosis undtill 6 months after discharge.

Read the detailed description

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.

02

Conditions studied

  • Anemia
  • Endocarditis, Bacterial
03

In context

Anemia

1,810 studies on the registry are indexed under Anemia; 215 are open to participants now.

This study's enrollment of 209 is below the median of 270 across 368 observational studies indexed under Anemia.

Browse Anemia studies →

Lead sponsor

Rigshospitalet, Denmark is the lead sponsor of 1,007 studies on the registry; 175 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

100 patients with IE, 30 undergoing elective TAVI/TECAR, 30 with non-IE bacterial infections and 30 healthy blood donors

Eligibility criteria

IE-patients:

Inclusion Criteria:

  • Infectious endocarditis, defined by Duke criteria

Exclusion Criteria:

  • Known rheumatic disease or immune defect

TAVI/TEVAR patients:

Inclusion Criteria:

  • Scheduled for a TAVI/TEVAR procedure

Exclusion criteria:

  • Clinical suspicion of infection
  • Known rheumatic disease or immune defect

Bacterial patients without IE (short infection):

Inclusion criteria

  • Patients admitted with an infection with gram positive bacteria, without IE Exclusion criteria
  • Known rheumatic disease or immune defect

Blood donors:

Exclusion criteria:

  • Antibiotic treatment within the last 2 months
  • Cancer, rheumatic disease or other known inflammatory disease
  • Surgery within the last 3 months
  • Pregnancy
05

Study design

Observational model
Case-control
Time perspective
Prospective
Enrollment
209 participants (actual)
Patient registry
No
Biospecimen retention
Samples without dna

Groups and cohorts

  • Endocarditis

    100 patients diagnosed with infectious endocarditis according to DUKE criteria. Detailed characterization of inflammation, anemia and markers of iron hemostatis will be made at diagnosis and followed undtill 6 months after discharge.

    Other: Measurement of biomarkers for inflammation and anemia

  • TAVI/TEVAR patietns

    30 patients undergoing elektive TAVI/TEVAR procedures. Detailed characterization of inflammation, anemia and markers of iron hemostatis will be made at directly prior to procedure and followed undtill 3 months after discharge.

    Other: Measurement of biomarkers for inflammation and anemia

  • Patients with bacterial infections without endocarditis

    30 patients diagnosed with with bacterial infections, without endocarditis. Detailed characterization of inflammation, anemia and markers of iron hemostatis will be made at diagnosis and followed undtill 3 months after discharge.

    Other: Measurement of biomarkers for inflammation and anemia

  • Healthy blood donors

    Detailed characterization of inflammation, anemia and markers of iron hemostatis will be made at directly prior to blood donation and approximately 1 week after blood donations

    Other: Measurement of biomarkers for inflammation and anemia

Interventions

  • OtherMeasurement of biomarkers for inflammation and anemia

    Measurement of biomarkers for inflammation and anemia, in addition to standart clinical measurements

06

What researchers measure

Primary outcomes

  1. Prevalence of anemia during hospitalization

    Diagnosis of anemia through WHO/NCI criteria for anemia and severity of anemia at time of diagnosis, 1-4 weeks after initiation of relevant treatment and up to 6 months after discharge

    Time frame: From time of diagnosis/intervention untill end of follow-up (up to 6 months from inclusion)

Secondary outcomes

  1. Prevalence of iron deficiency anemia in patients with IE and relevant controls

    Determination of the prevalence of iron deficiency anemia through measurements of hemoglobin, markers of anemia and of iron metabolism/stores in blood

    Time frame: From time of diagnosis/intervention untill end of follow-up (up to 6 months from inclusion)

  2. Prevalence of anemia due to inflammation in patients with IE and relevant controls

    Determination of the prevalence of anemia og inflammation through measurements of markers of anemia of inflammation (IL-6 hepcidin, erytroferrone, soluble transferrin receptor)

    Time frame: From time of diagnosis/intervention untill end of follow-up (up to 6 months from inclusion)

  3. Time untill resolution of inflammation and anemia in patients with IE and relevant controls

    Determination of time from start of treatment/intervention until normalization of markers of inflammation and anemia, as well as normalization of erythropoiesis

    Time frame: From time of diagnosis/intervention untill end of follow-up (up to 6 months from inclusion)

07

Study locations

1 site
  • Rigshospitalet
    Copenhagen, 2100, Denmark
08

References and documents

Individual participant data

Plan to share: Undecided — Available on reasonable request

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 26, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04840225
Responsible party
Mia Pries-Heje (MD, Rigshospitalet, Denmark) — Principal investigator
First posted
Apr 9, 2021
Start date
Mar 22, 2021
Primary completion
Mar 29, 2023
Completion
Jun 29, 2023
Last update
Sep 26, 2025

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Sep 2025. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion