TY - JOUR
T1 - A single dose of erythropoietin in ST-elevation myocardial infarction
AU - Voors, Adriaan A.
AU - Belonje, Anne M. S.
AU - Zijlstra, Felix
AU - Hillege, Hans L.
AU - Anker, Stefan D.
AU - Slart, Riemer H. J. A.
AU - Tio, Rene A.
AU - Van't Hof, Arnoud
AU - Jukema, J. Wouter
AU - Peels, Hans Otto J.
AU - Henriques, Jose P. S.
AU - ten Berg, Jurrien M.
AU - Vos, Jeroen
AU - van Gilst, Wiek H.
AU - van Veldhuisen, Dirk J.
AU - HEBE III Investigators
AU - Veeger, Nic
PY - 2010/11
Y1 - 2010/11
N2 - 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).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 000IU 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).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
AB - 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).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 000IU 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).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
KW - ST-elevation myocardial infarction
KW - Erythropoietin
KW - Left ventricular function
KW - Cardiovascular events
KW - Infarct size
KW - IMPROVES CARDIAC-FUNCTION
KW - RECOMBINANT-HUMAN-ERYTHROPOIETIN
KW - ISCHEMIA-REPERFUSION INJURY
KW - HEART-FAILURE
KW - ENDOGENOUS ERYTHROPOIETIN
KW - DARBEPOETIN-ALPHA
KW - NEOVASCULARIZATION
KW - TRIAL
KW - ISCHEMIA/REPERFUSION
KW - FEASIBILITY
U2 - 10.1093/eurheartj/ehq304
DO - 10.1093/eurheartj/ehq304
M3 - Article
C2 - 20802250
SN - 0195-668X
VL - 31
SP - 2593
EP - 2600
JO - European Heart Journal
JF - European Heart Journal
IS - 21
ER -