title: Erythropoietin in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: a randomized, double-blind trial.
abstract: 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.
authors.affiliation: 1. Medizinische Klinik rechts der Isar, Munich, Germany. ott@dhm.mhn.de
authors.forename: Ilka
authors.initials: I
authors.lastname: Ott
authors.forename: Stefanie
authors.initials: S
authors.lastname: Schulz
authors.forename: Julinda
authors.initials: J
authors.lastname: Mehilli
authors.forename: Stefanie
authors.initials: S
authors.lastname: Fichtner
authors.forename: Martin
authors.initials: M
authors.lastname: Hadamitzky
authors.forename: Katharina
authors.initials: K
authors.lastname: Hoppe
authors.forename: Tareq
authors.initials: T
authors.lastname: Ibrahim
authors.forename: Steffan
authors.initials: S
authors.lastname: Martinoff
authors.forename: Steffen
authors.initials: S
authors.lastname: Massberg
authors.forename: Karl-Ludwig
authors.initials: KL
authors.lastname: Laugwitz
authors.forename: Josef
authors.initials: J
authors.lastname: Dirschinger
authors.forename: Markus
authors.initials: M
authors.lastname: Schwaiger
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
authors.forename: Albert
authors.initials: A
authors.lastname: Schmig
mesh_terms: 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
chemical_list: D004921:Erythropoietin