Document Detail


A single dose of erythropoietin in ST-elevation myocardial infarction.
MedLine Citation:
PMID:  20802250     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Cardioprotective effects of erythropoietin (EPO) have been shown in experimental and smaller clinical studies. We performed a prospective, multicentre, randomized trial to assess the effects of a single high dose of EPO after primary coronary intervention (PCI) for an ST-elevation myocardial infarction (STEMI). Methods and results Patients with a successful PCI for a first STEMI were randomized to receive either standard medical care alone, or in combination with a single bolus with 60,000 IU i.v. of epoetin alfa within 3 h after PCI. Primary endpoint was left ventricular ejection fraction (LVEF) after 6 weeks, assessed by planar radionuclide ventriculography. Pre-specified secondary endpoints included enzymatic infarct size and major adverse cardiovascular events. A total of 529 patients were enrolled (EPO n = 263, control n = 266). At baseline (before EPO administration), groups were well-matched for all relevant characteristics. After a mean of 6.5 (± 2.0) weeks, LVEF was 0.53 (± 0.10) in the EPO group and 0.52 (± 0.11) in the control group (P = 0.41). Median area under the curve (inter-quartile range) after 72 h for creatinine kinase was 50 136 (28 212-76 664)U/L per 72 h in the EPO group and 53 510 (33 973-90 486)U/L per 72 h in the control group (P = 0.058). More major adverse cardiac events occurred in the control than in the EPO group (19 vs. 8; P = 0.032). Conclusion A single high dose of EPO after a successful PCI for a STEMI did not improve LVEF after 6 weeks. However, the use of EPO was related to less major adverse cardiovascular events and a favourable clinical safety profile.
CLINICAL TRIAL REGISTRATION INFORMATION: NCT00449488; http://www.clinicaltrials.gov/ct2/show/NCT00449488?term=voors&rank=2.
Authors:
Adriaan A Voors; Anne M S Belonje; Felix Zijlstra; Hans L Hillege; Stefan D Anker; Riemer H J A Slart; René A Tio; Arnoud van 't Hof; J Wouter Jukema; Hans Otto J Peels; José P S Henriques; Jurriën M Ten Berg; Jeroen Vos; Wiek H van Gilst; Dirk J van Veldhuisen;
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-08-29
Journal Detail:
Title:  European heart journal     Volume:  31     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-02     Completed Date:  2011-11-23     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  2593-600     Citation Subset:  IM    
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00449488
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon, Coronary / methods
Combined Modality Therapy
Electrocardiography
Erythropoietin / administration & dosage*
Female
Hematinics / administration & dosage*
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Myocardial Infarction / radionuclide imaging,  therapy*
Prospective Studies
Radionuclide Ventriculography / methods
Recombinant Proteins / administration & dosage
Treatment Failure
Ventricular Dysfunction, Left / therapy
Chemical
Reg. No./Substance:
0/Hematinics; 0/Recombinant Proteins; 11096-26-7/Erythropoietin; 113427-24-0/epoetin alfa
Investigator
Investigator/Affiliation:
A A Voors / ; D J van Veldhuisen / ; F Zijlstra / ; A M S Belonje / ; H L Hillege / ; S D Anker / ; R A Slart / ; R A Tio / ; A van 't Hof / ; J W Jukema / ; J P S Henriques / ; J M ten Berg / ; J Vos / ; W H van Gilst / ; J G Tijssen / ; M van den Brand / ; B J de Smet / ; A F van den Heuvel / ; N Veeger /
Comments/Corrections
Comment In:
Nat Rev Cardiol. 2010 Nov;7(11):600   [PMID:  21080604 ]
Eur Heart J. 2010 Nov;31(21):2577-9   [PMID:  20802249 ]

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