Erythropoietin in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: a randomized, double-blind trial.
BACKGROUND
Erythropoietin improves myocardial function in experimental models of myocardial infarction. The aim of the present study was to determine the value of erythropoietin in patients with acute ST-elevation myocardial infarction.


RESULTS
This randomized, double-blind study included 138 patients admitted with acute ST-elevation myocardial infarction and treated with primary percutaneous coronary intervention. Patients were randomly assigned to receive epoetin-β (3.33×104 U, n=68) or placebo (n=70) immediately and at 24 and 48 hours after percutaneous coronary intervention. The primary end point was left ventricular ejection fraction after 6 months measured by MRI. Other end points included infarct size at 5 days and 6 months. Clinical adverse events (death, recurrent myocardial infarction, stroke, and infarct-related artery revascularization) were investigated at 30 days and 6 months. Left ventricular ejection fraction at 6-month follow-up was 52.0±9.1% in the erythropoietin group compared with 51.8±9.3% in the placebo group (P=0.92). Five days after percutaneous coronary intervention, left ventricular ejection fraction was 49.4±8.0% in the erythropoietin group and 50.8±7.3% in the placebo group (P=0.32); infarct size was 26.8±20.9% and 28.3±24.4% (P=0.76) and decreased to 17.3±14.3% and 20.9±16.4% at 6-month follow-up (P=0.27). The cumulative 6-month incidence of death, recurrent myocardial infarction, stroke or target vessel revascularization was 13.2% in the erythropoietin group and 5.7% in the placebo group (hazard ratio, 2.36; 95% confidence interval, 0.73 to 7.66; P=0.15).


CONCLUSIONS
In patients with acute ST-elevation myocardial infarction treated with primary percutaneous coronary intervention, erythropoietin treatment did not improve left ventricular ejection fraction or reduce infarct size but may increase clinical adverse events.


BACKGROUND
URL: http://www.clinicaltrials.gov. Unique identifier: NCT00390832.
Ott
Ilka
I
1. Medizinische Klinik rechts der Isar, Munich, Germany. ott@dhm.mhn.de
Schulz
Stefanie
S
Mehilli
Julinda
J
Fichtner
Stefanie
S
Hadamitzky
Martin
M
Hoppe
Katharina
K
Ibrahim
Tareq
T
Martinoff
Steffan
S
Massberg
Steffen
S
Laugwitz
Karl-Ludwig
KL
Dirschinger
Josef
J
Schwaiger
Markus
M
Kastrati
Adnan
A
Schmig
Albert
A
D000368:Aged; D017130:Angioplasty; D004311:Double-Blind Method; D004562:Electrocardiography; D004921:Erythropoietin / Q000008:administration & dosage* / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D009204:Myocardial Revascularization; D009206:Myocardium / Q000473:pathology*; D012008:Recurrence; D020521:Stroke; D013318:Stroke Volume; D016019:Survival Analysis; D016896:Treatment Outcome
D004921:Erythropoietin