Long Term Effects of Epoetin Alfa in Patients with ST- Elevation Myocardial Infarction

Fokkema, Marieke L.; Kleijn, Lennaert; Meer, Peter van der; Belonje, Anne M.; Achterhof, Sandra K.; Hillege, Hans L.; Hof, Arnoud van ’t; Jukema, J. Wouter; Peels, Hans O.; Henriques, José P.S.; Berg, Jurriën Ten; Vos, Jeroen; Gilst, Wiek H. van; Veldhuisen, Dirk J. van; Voors, Adriaan A.

doi:10.1007/s10557-013-6470-0

Cited by 12 publications

(11 citation statements)

References 31 publications

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“…Randomized studies comparing different transfusion thresholds failed to show any advantage with a more liberal cut‐off of 9 to 10 g/dL, substantiating current recommendations to transfuse at more restrictive levels of 7 to 8 g/dL . Another strategy involves the administration of erythropoietin, a hematopoietic hormone produced by the kidneys in response to hypoxia, which was hypothesized to improve outcomes in patients with ACS. However, studies investigating the injection of erythropoiesis‐stimulating agent (eg, erythropoietin) in ST‐segment elevation myocardial infarction patients failed to show a benefit, with at least 1 study demonstrating an increased risk of death, myocardial infarction, and stroke associated with such therapy .…”

Section: Introductionmentioning

confidence: 89%

“…Another strategy involves the administration of erythropoietin, a hematopoietic hormone produced by the kidneys in response to hypoxia, which was hypothesized to improve outcomes in patients with ACS. However, studies investigating the injection of erythropoiesis‐stimulating agent (eg, erythropoietin) in ST‐segment elevation myocardial infarction patients failed to show a benefit, with at least 1 study demonstrating an increased risk of death, myocardial infarction, and stroke associated with such therapy . In contrast, intravenous iron substitution did improve functional capacity and quality of life in anemic patients with heart failure .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Anemia and Acute Coronary Syndrome: Time for Intervention Studies

Farhan

Baber

Mehran

2016

JAHA

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Section: Introductionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Anemia and Acute Coronary Syndrome: Time for Intervention Studies

Farhan

Baber

Mehran

2016

JAHA

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“…However, larger randomized phase II trials REVEAL [293] and HEBE III [294, 295] failed to show any significant improvement in heart function and, instead, EPO treatment was associated with an increase in infarct size among older patients. Based on these findings, the effectiveness of EPO in the treatment of coronary artery disease has been questioned [296–298].…”

Section: Progress In Clinical Translationmentioning

confidence: 99%

Signaling Pathways in Cardiac Myocyte Apoptosis

Xia

Liu

Cheng

2016

BioMed Research International

130

127

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Cardiovascular diseases, the number 1 cause of death worldwide, are frequently associated with apoptotic death of cardiac myocytes. Since cardiomyocyte apoptosis is a highly regulated process, pharmacological intervention of apoptosis pathways may represent a promising therapeutic strategy for a number of cardiovascular diseases and disorders including myocardial infarction, ischemia/reperfusion injury, chemotherapy cardiotoxicity, and end-stage heart failure. Despite rapid growth of our knowledge in apoptosis signaling pathways, a clinically applicable treatment targeting this cellular process is currently unavailable. To help identify potential innovative directions for future research, it is necessary to have a full understanding of the apoptotic pathways currently known to be functional in cardiac myocytes. Here, we summarize recent progress in the regulation of cardiomyocyte apoptosis by multiple signaling molecules and pathways, with a focus on the involvement of these pathways in the pathogenesis of heart disease. In addition, we provide an update regarding bench to bedside translation of this knowledge and discuss unanswered questions that need further investigation.

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“…10) Other studies showed high-dose r-HuEPO was safe for shortand long-term cardiovascular outcomes in patients with STEMI. 41,42) In the present study, composite cardiovascular events occurred in 5 patients in the darbepoetin-α group and in 3 patients in the control group. However, thromboembolic events occurred in 1 patient in the darbepoetinα group, with 3 events in the control group.…”

Section: Efficacy Of Intracoronary Darbepoetin-α In Stemimentioning

confidence: 46%

Efficacy of IntraCoronary Erythropoietin Delivery BEfore Reperfusion-Gauging Infarct Size in Patients with Acute ST-segment Elevation Myocardial Infarction (ICEBERG)

Seo

Suh

et al. 2019

Int. Heart J.

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Previous clinical studies have shown inconsistent results regarding the effect of erythropoietin in STsegment elevation myocardial infarction (STEMI). This study investigated whether directed intracoronary infusion of darbepoetin-α into ischemic myocardium before reperfusion would reduce infarct size or post-infarct remodeling in STEMI patients. Eighty STEMI patients received one of the following treatments simultaneously with the first balloon inflation: intracoronary darbepoetin-α 300 μg (n = 40) or saline (n = 40), administered via the over-the-wire balloon system. The primary endpoint was infarct size estimated by serial cardiac enzyme levels after procedure. The secondary endpoints were (1) infarct size and proportion of salvaged myocardium measured with cardiac magnetic resonance (CMR) at baseline; (2) post-infarct remodeling (PIR), defined as an increase in left ventricular end-diastolic volume more than 20% at 4 months compared to the baseline on CMR; and (3) composite cardiovascular endpoints assessed at 4 months. The peak CK-MB [median 270.0 (interquartile range 139.8-356.3) versus 231.5 (131.0-408.5) ng/mL, P = 0.55] and troponin-I [128.5 (63.5-227.8) versus 109.0 (43.8-220.0) ng/mL, P = 0.52)] did not differ between the darbepoetin-α and control group. Fifty-seven patients completed the baseline and 4-month follow-up CMR. There were no differences in infarct size [30.6 (18.1-49.8) versus 31.5 (22.5-47.3) cm 3 , P = 0.91), proportion of salvaged myocardium [26.7% (15.9-42.6%) versus 35.8% (22.4-48.8%), P = 0.12) or PIR (8.0% versus 6.7%, P = 0.62) between the two groups. Composite cardiovascular outcomes did not differ between the two groups. In conclusion, administration of intracoronary darbepoetin-α before reperfusion did not reduce infarct size or post-infarct remodeling in STEMI patients.

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Long Term Effects of Epoetin Alfa in Patients with ST- Elevation Myocardial Infarction

Cited by 12 publications

References 31 publications

Anemia and Acute Coronary Syndrome: Time for Intervention Studies

Anemia and Acute Coronary Syndrome: Time for Intervention Studies

Signaling Pathways in Cardiac Myocyte Apoptosis

Efficacy of IntraCoronary Erythropoietin Delivery BEfore Reperfusion-Gauging Infarct Size in Patients with Acute ST-segment Elevation Myocardial Infarction (ICEBERG)

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