High serum erythropoietin level is associated with smaller infarct size in patients with acute myocardial infarction who undergo successful primary percutaneous coronary intervention.
OBJECTIVE
We investigated whether a higher serum erythropoietin (EPO) level in patients with acute myocardial infarction (MI) subjected to successful primary percutaneous coronary intervention (PCI) can predict a smaller infarct size determined by creatine kinase (CK) release.


BACKGROUND
Erythropoietin has been shown to protect cardiomyocytes from ischemia-reperfusion injury in rodents.


METHODS
We prospectively studied 101 patients with first MI who received successful primary PCI within 12 h from the onset of MI. Blood samples were collected to examine the serum EPO level after the primary PCI and within 24 h from the onset of MI.


RESULTS
The peak CK level and cumulative CK release were significantly lower in the above-median EPO group than in the below-median EPO group. Thrombolysis In Myocardial Infarction (TIMI) grades and collateral grades before PCI, infarct-related coronary arteries, time to the successful reperfusion from the onset of MI, and serum creatinine levels were similar in the two EPO groups. A stepwise multiple regression analysis revealed that the absolute serum EPO level (mU/ml) as well as TIMI grades after PCI and preinfarction angina was an independent predictor for the cumulative CK release.


CONCLUSIONS
These data suggest that a high endogenous EPO level can predict a smaller infarct size in patients with acute MI subjected to successful primary PCI. This might be attributed to the potentially protective effect of endogenous EPO against ischemia-reperfusion injury in humans.
Namiuchi
Shigeto
S
Department of Cardiology, Iwaki Kyoritsu General Hospital, Iwaki, Japan.
Kagaya
Yutaka
Y
Ohta
Jun
J
Shiba
Nobuyuki
N
Sugi
Masafumi
M
Oikawa
Masayoshi
M
Kunii
Hiroyuki
H
Yamao
Hidetsugu
H
Komatsu
Nobuo
N
Yui
Mitsuru
M
Tada
Hiroko
H
Sakuma
Masahito
M
Watanabe
Jun
J
Ichihara
Toshikatsu
T
Shirato
Kunio
K
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood; D004921:Erythropoietin / Q000097:blood*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009203:Myocardial Infarction / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011446:Prospective Studies
D004921:Erythropoietin; D020097:Natriuretic Peptide, Brain; D003402:Creatine Kinase