title: The influence of Erythropoietin on platelet activation, thrombin generation and FVII/active FVII in patients with AMI.
abstract: BACKGROUND
  Erythropoietin (Epo) has been shown to improve myocardial function in models of experimental myocardial infarction, but has also been associated with a rise in thromboembolic events. Thus, the aim of this study was to investigate the influence of Epo on platelet activation and coagulation in patients with acute myocardial infarction (AMI).
  
  
  METHODS
  The study was designed as a substudy of the randomised, double-blind, placebo controlled REVIVAL-3 (REgeneration of VItal Myocardium in ST-Segment EleVation MyocardiAL Infarction by Erythropoietin) study that investigated the effects of recombinant human Epo in AMI. Serial venous blood samples were collected before and after study medication. Circulating prothrombin fragment F1 + 2, FVII, active FVII, beta thromboglobulin (TG) and P-Selectin were measured before and 60 hours after randomization by immunoassay (n = 94). In a randomly selected subgroup platelet aggregation was measured using whole blood aggregometry (Multiplate Analyzer, n = 45).
  
  
  RESULTS
  After 5 days an increase in FVII was observed after Epo as compared to placebo (P = 0.02), yet active FVII and prothrombin fragment F1 + 2 remained unchanged. Moreover, no statistically significant differences in circulating TG or P-selectin were observed between the groups. As an expected response to peri-interventional therapy with clopidogrel and aspirin, platelet aggregation after stimulation with ADP, TRAP, ASPI or collagen decreased 12 hours and 2 days after PCI. However, no difference between the Epo and the placebo group was observed.
  
  
  CONCLUSIONS
  After treatment with Epo in patients with AMI a slight increase in circulating FVII after Epo was not associated with an increase in active FVII, prothrombin fragment F1 + 2, TG or P-selectin. Moreover, platelet aggregation was not altered after treatment with Epo as compared to placebo.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier: NCT01761435.
authors.affiliation: Deutsches Herzzentrum der Technischen Universität München, Lazarettstr. 36, München, 80636, Germany.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Demetz
authors.affiliation: Deutsches Herzzentrum der Technischen Universität München, Lazarettstr. 36, München, 80636, Germany.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Laux
authors.affiliation: Pharmaceutical Division, F. Hoffmann-La Roche, Basel, Switzerland.
authors.forename: Armin
authors.initials: A
authors.lastname: Scherhag
authors.affiliation: Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Tiny
authors.initials: T
authors.lastname: Hoekstra
authors.affiliation: Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Marit M
authors.initials: MM
authors.lastname: Suttorp
authors.affiliation: Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Friedo
authors.initials: F
authors.lastname: Dekker
authors.affiliation: Department of Clinical Chemistry and Haematology, University Medical Center, Utrecht, The Netherlands.
authors.forename: Mark
authors.initials: M
authors.lastname: Roest
authors.affiliation: Interdisciplinary Center for Technology Analysis & Forecasting (ICTAF), Tel Aviv University, Tel Aviv, 69978, Israel.
authors.forename: Mira
authors.initials: M
authors.lastname: Marcus-Kalish
authors.affiliation: Department of Medicine A, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Moshe
authors.initials: M
authors.lastname: Mittelman
authors.affiliation: Deutsches Herzzentrum der Technischen Universität München, Lazarettstr. 36, München, 80636, Germany.
authors.forename: Ilka
authors.initials: I
authors.lastname: Ott
keywords: AMI; Erythropoietin; PCI; Platelet activation