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RED-HF Trial Reduction of Events with Darbepoetin alfa in Heart Failure Trial Duke Heart Failure Research Pager: 970-0736 Purpose  Assess efficacy and safety of Darbepoetin alfa treatment on mortality and morbidity in heart failure subjects with symptomatic left ventricular systolic dysfunction and anemia Darbepoetin alfa – glycoprotein that stimulates erythropoietin, a hormone released from the kidney that develops red blood cells and produces hemoglobin Inclusion Criteria  EF ≤ 40%  HF ≥ 3 months & NYHA class II, III, or IV at randomization • ≥18 years old ● Hemoglobin ≥9 and ≤12 g/dL ● On stable medical therapy Interventions Randomization 1:1 Darbepoetin alfa SC injection Placebo SC injection Nursing Roles  If an enrolled subject is admitted to the hospital, please notify the research team (970-0736) so that the study drug can be obtained and administrated at the appropriate time.  Side effects of Darbepoetin alfa (See Adverse Reactions List): http://www.clinicalpharmacologyip.com/Forms/Monograph/monograph.aspx?cpnu m=2571&sec=monadve Outcomes  Why is this study being done?  To compare the efficacy of Darbepoetin alfa to placebo as measured by the time to:  1st hospital admission for worsening HF or  death