title: Long term effects of epoetin alfa in patients with ST- elevation myocardial infarction.
abstract: OBJECTIVE
  The HEBE III trial showed that epoetin alfa administration in patients with a first ST-elevation myocardial infarction (STEMI) did not improve left ventricular function at 6 weeks after primary percutaneous coronary intervention (PCI). The long term effects of erythropoiesis- stimulating agents on cardiovascular morbidity and mortality are unknown, therefore we evaluated clinical events at 1 year after PCI.
  
  
  METHODS
  A total of 529 patients with a first STEMI and successful primary PCI were randomized to standard optimal medical treatment (N = 266) or an additional bolus of 60,000 IU epoetin alfa administered intravenously (N = 263) within 3 h after PCI. Analyses were performed by intention to treat.
  
  
  RESULTS
  At 1 year after STEMI, 485 patients had complete follow-up. The rate of the composite end point of all-cause mortality, re-infarction, target vessel revascularization, stroke and/or heart failure was 6.4 % (N = 15) in the epoetin alfa group and 9.6 % (N = 24) in the control group (p = 0.18). Thromboembolic events were present in 1.3 % (N = 3) of patients in the epoetin alfa group and 2.4 % (N = 6) in the control group. There was no evidence of benefit from epoetin alfa administration in subgroups of patients.
  
  
  CONCLUSIONS
  Administration of a single bolus of epoetin alfa in patients with STEMI does not result in a reduction of cardiovascular events at 1 year after primary PCI. There was a comparable incidence of thromboembolic complications in both treatment groups, suggesting that epoetin alfa administration is safe at long term.
authors.affiliation: Department of Cardiology, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.
authors.forename: Marieke L
authors.initials: ML
authors.lastname: Fokkema
authors.forename: Lennaert
authors.initials: L
authors.lastname: Kleijn
authors.forename: Peter
authors.initials: P
authors.lastname: van der Meer
authors.forename: Anne M
authors.initials: AM
authors.lastname: Belonje
authors.forename: Sandra K
authors.initials: SK
authors.lastname: Achterhof
authors.forename: Hans L
authors.initials: HL
authors.lastname: Hillege
authors.forename: Arnoud
authors.initials: A
authors.lastname: van 't Hof
authors.forename: J Wouter
authors.initials: JW
authors.lastname: Jukema
authors.forename: Hans O
authors.initials: HO
authors.lastname: Peels
authors.forename: José P
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
authors.forename: Adriaan A
authors.initials: AA
authors.lastname: Voors
mesh_terms: D000368:Aged; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006397:Hematinics / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D011994:Recombinant Proteins / Q000008:administration & dosage; D013923:Thromboembolism / Q000209:etiology
chemical_list: D006397:Hematinics; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa