Document Detail


Erythropoietin prevention trial of coronary restenosis and cardiac remodeling after ST-elevated acute myocardial infarction (EPOC-AMI): a pilot, randomized, placebo-controlled study.
MedLine Citation:
PMID:  20834185     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Erythropoietin (EPO) enhances re-endothelialization and anti-apoptotic action. Larger clinical studies to examine the effects of high-dose EPO are in progress in patients with acute myocardial infarction (AMI).
METHODS AND RESULTS: The aim of this multi-center pilot study was to investigate the effect of `low-dose EPO' (6,000 IU during percutaneous coronary intervention (PCI), 24 h and 48 h) in 35 patients with a first ST-elevated AMI undergoing PCI who was randomly assigned to EPO or placebo (saline) treatment. Neointimal volume, cardiac function and infarct size were examined in the acute phase and 6 months later (ClinicalTrials.gov identifier: NCT00423020). No significant regression in in-stent neointimal volume was observed, whereas left ventricular (LV) ejection fraction was significantly improved (49.2% to 55.7%, P=0.003) and LV end-systolic volume was decreased in the EPO group (47.7 ml to 39.0 ml, P=0.036). LV end-diastolic volume tended to be reduced from 90.2% to 84.5% (P=0.159), whereas in the control group it was inversely increased (91.7% to 93.7%, P=0.385). Infarction sizes were significantly reduced by 38.5% (P=0.003) but not in the control group (23.7%, P=0.051). Hemoglobin, peak creatine kinase values, and CD34(+)/CD133(+)/CD45(dim) endothelial progenitors showed no significant changes. No adverse events were observed during study periods.
CONCLUSIONS: This is a first study demonstrating that short-term `low-dose' EPO to PCI-treated AMI patients did not prevent neointimal hyperplasia but rather improved cardiac function and infarct size without any clinical adverse effects.
Authors:
Norimasa Taniguchi; Takeshi Nakamura; Takahisa Sawada; Kinya Matsubara; Keizo Furukawa; Mitsuyoshi Hadase; Yoshifumi Nakahara; Takashi Nakamura; Hiroaki Matsubara
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial     Date:  2010-09-08
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  74     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-29     Completed Date:  2010-11-30     Revised Date:  2011-02-18    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  2365-71     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Sakurakai Takahashi Hospital, Kobe, Japan.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00423020
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon, Coronary* / adverse effects
Biological Markers / blood
Cardiovascular Agents / administration & dosage*,  adverse effects
Chi-Square Distribution
Coronary Angiography
Coronary Restenosis / diagnosis,  etiology,  prevention & control*
Creatine Kinase / blood
Endothelial Cells / drug effects,  pathology
Erythropoietin, Recombinant / administration & dosage*,  adverse effects
Female
Hemoglobins / metabolism
Humans
Hyperplasia
Japan
Male
Middle Aged
Myocardial Infarction / diagnosis,  physiopathology,  therapy*
Myocardium / pathology
Pilot Projects
Placebo Effect
Prospective Studies
Stem Cells / drug effects,  pathology
Stroke Volume / drug effects
Time Factors
Treatment Outcome
Ultrasonography, Interventional
Ventricular Function, Left / drug effects
Ventricular Remodeling / drug effects*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Cardiovascular Agents; 0/Erythropoietin, Recombinant; 0/Hemoglobins; 0/epoetin beta; EC 2.7.3.2/Creatine Kinase
Comments/Corrections
Comment In:
Circ J. 2010 Nov;74(11):2290-2   [PMID:  20962420 ]

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