title: A single dose of erythropoietin in ST-elevation myocardial infarction.
abstract: OBJECTIVE
  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.
  
  
  BACKGROUND
  NCT00449488; http://www.clinicaltrials.gov/ct2/show/NCT00449488?term=voors&rank=2.
authors.affiliation: Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands. a.a.voors@thorax.umcg.nl
authors.forename: Adriaan A
authors.initials: AA
authors.lastname: Voors
authors.forename: Anne M S
authors.initials: AM
authors.lastname: Belonje
authors.forename: Felix
authors.initials: F
authors.lastname: Zijlstra
authors.forename: Hans L
authors.initials: HL
authors.lastname: Hillege
authors.forename: Stefan D
authors.initials: SD
authors.lastname: Anker
authors.forename: Riemer H J A
authors.initials: RH
authors.lastname: Slart
authors.forename: René A
authors.initials: RA
authors.lastname: Tio
authors.forename: Arnoud
authors.initials: A
authors.lastname: van 't Hof
authors.forename: J Wouter
authors.initials: JW
authors.lastname: Jukema
authors.forename: Hans Otto J
authors.initials: HO
authors.lastname: Peels
authors.forename: José P S
authors.initials: JP
authors.lastname: Henriques
authors.forename: Jurriën M
authors.initials: JM
authors.lastname: Ten Berg
authors.forename: Jeroen
authors.initials: J
authors.lastname: Vos
authors.forename: Wiek H
authors.initials: WH
authors.lastname: van Gilst
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: van Veldhuisen
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D003131:Combined Modality Therapy; D004562:Electrocardiography; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006397:Hematinics / Q000008:administration & dosage*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D011446:Prospective Studies; D015635:Radionuclide Ventriculography / Q000379:methods; D011994:Recombinant Proteins / Q000008:administration & dosage; D017211:Treatment Failure; D018487:Ventricular Dysfunction, Left / Q000628:therapy
chemical_list: D006397:Hematinics; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa