title: Erythropoietin treatment in patients with acute myocardial infarction: a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  In experimental models of acute myocardial infarction (AMI), erythropoietin (EPO) reduces infarct size and improves left ventricular (LV) function. However, in the clinical setting, the effect of EPO in AMI was unclear. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) of EPO to explore the safety and therapeutic effects of EPO in patients with AMI.
  
  
  METHODS
  We identified reports of RCTs comparing EPO to placebo for AMI in adult humans in PubMed, Cochrane Central Register of Controlled Trials, and EMBASE. Outcomes included all-cause mortality, major cardiovascular events, cardiac function by LV ejection fraction and infarct size.
  
  
  RESULTS
  We included 13 articles of RCTs with data for 1,564 patients. Erythropoietin therapy did not improve LV ejection fraction (weighted mean difference [WMD] 0.33, 95% CI -1.90 to 1.24, P = .68) and had no effect on infarct size, as measured by cardiac magnetic resonance imaging (WMD -0.12, -2.16 to 1.91, P = .90) or serum peak value of creatine kinase-MB (WMD -2.01, -25.70 to 21.68, P = .87). Erythropoietin treatment did not decrease the risk of total adverse cardiac events (relative risk [RR] 1.02, 0.65-1.61, P = .92). Erythropoietin treatment also failed to decrease the risk of heart failure (RR, 0.69, 0.27-1.72, P = .42) and all-cause mortality (RR 0.55, 0.22-1.33, P = .18). Moreover, EPO had no effect on the risk of stent thrombosis (RR, 0.69, 0.29-1.64, P = .40).
  
  
  CONCLUSIONS
  Erythropoietin in patients with AMI seems to have no clinical benefit for heart function or reducing infarct size, cardiovascular events, and all-cause mortality. Erythropoietin may not be a choice for patients with AMI.
authors.affiliation: Department of Cardiology, The Second Affiliated Hospital, Xi'an Jiaotong University School of Medicine, Xi'an, Shaanxi, PR China. gaomedic@163.com
authors.forename: Dengfeng
authors.initials: D
authors.lastname: Gao
authors.forename: Ning
authors.initials: N
authors.lastname: Ning
authors.forename: Xiaolin
authors.initials: X
authors.lastname: Niu
authors.forename: Yinhu
authors.initials: Y
authors.lastname: Dang
authors.forename: Xin
authors.initials: X
authors.lastname: Dong
authors.forename: Jin
authors.initials: J
authors.lastname: Wei
authors.forename: Canzhan
authors.initials: C
authors.lastname: Zhu
mesh_terms: D000328:Adult; D000368:Aged; D002317:Cardiovascular Agents / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004921:Erythropoietin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D013318:Stroke Volume / Q000187:drug effects; D015996:Survival Rate; D013927:Thrombosis / Q000209:etiology; D017211:Treatment Failure; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D002317:Cardiovascular Agents; D004921:Erythropoietin