title: Effect of Erythropoietin in patients with acute myocardial infarction: five-year results of the REVIVAL-3 trial.
abstract: Erythropoietin (EPO) has been suggested to promote cardiac repair after MI. However, the randomized, double-blind, placebo controlled REVIVAL-3 trial showed that short term high dose EPO in timely reperfused myocardium does not improve left ventricular ejection fraction after 6 months. Moreover, the study raised safety concerns due to a trend towards a higher incidence of adverse clinical events as well as a increase in neointima formation after treatment with EPO. The present study therefore aimed to assess the 5-year clinical outcomes.
  
  
  
  After successful reperfusion 138 patients with STEMI were randomly assigned to receive epoetin beta (3.33×104U, n = 68) or placebo (n = 70) immediately, 24 and 48 h after percutaneous coronary intervention. The primary outcome of the present study- the combined incidence of MACE 5 years after randomization - occurred in 25% of the patients assigned to epoetin beta and 17% of the patients assigned to placebo (RR 1.5; 95% CI 0.8-3.5; p = 0.26). Target lesion revascularization was required in 15 patients (22.1%) treated with epoetin-ß and 9 patients (12.9%) treated with placebo (p = 0.15). Analysis of patients in the upper and lower quartile of baseline hemoglobin as an indirect estimate of endogenous erythropoietin levels revealed no significant impact of endogenous erythropoietin on efficiency of exogen administered epoetin-ß in terms of death and MACE.
  
  
  
  These long-term follow-up data show that epoetin beta does not improve clinical outcomes of patients with acute myocardial infarction.
  
  
  
  URL www.clinicaltrials.gov ; Unique identifier NCT00390832; trial registration date October 19th 2006.
authors.affiliation: Deutsches Herzzentrum der Technischen Universität München, Lazarettstr. 36, 80636, Munich, Germany. bigitsteppich@yahoo.de.
authors.forename: Birgit
authors.identifier: 0000-0002-9388-7362
authors.initials: B
authors.lastname: Steppich
authors.affiliation: Deutsches Herzzentrum der Technischen Universität München, Lazarettstr. 36, 80636, Munich, Germany.
authors.forename: Philip
authors.initials: P
authors.lastname: Groha
authors.affiliation: Medizinische Klinik Klinikum rechts der Isar der Technischen Universität München, Ismaningerstr. 22, 81675, Munich, Germany.
authors.forename: Tareq
authors.initials: T
authors.lastname: Ibrahim
authors.affiliation: Medizinische Klinik Klinikum rechts der Isar der Technischen Universität München, Ismaningerstr. 22, 81675, Munich, Germany.
authors.forename: Heribert
authors.initials: H
authors.lastname: Schunkert
authors.affiliation: Medizinische Klinik Klinikum rechts der Isar der Technischen Universität München, Ismaningerstr. 22, 81675, Munich, Germany.
authors.forename: Karl-Ludwig
authors.initials: KL
authors.lastname: Laugwitz
authors.affiliation: Deutsches Herzzentrum der Technischen Universität München, Lazarettstr. 36, 80636, Munich, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Hadamitzky
authors.affiliation: Deutsches Herzzentrum der Technischen Universität München, Lazarettstr. 36, 80636, Munich, Germany.
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
authors.affiliation: Deutsches Herzzentrum der Technischen Universität München, Lazarettstr. 36, 80636, Munich, Germany.
authors.forename: Ilka
authors.initials: I
authors.lastname: Ott
mesh_terms: D017023:Coronary Angiography; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage; D000072657:ST Elevation Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D011994:Recombinant Proteins; C103998:epoetin beta; D004921:Erythropoietin
keywords: Acute myocardial infarction; Erythropoietin; REVIVAL-3 trial