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High-Dose Erythropoietin in Acute ST-Segment Elevation Myocardial Infarction: A Meta-Analysis of Randomized Controlled Trials

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Abstract

Objective

We sought to perform a meta-analysis to evaluate the potential influence of high-dose erythropoietin (EPO) on cardiac function parameters in patients with acute ST-segment elevation myocardial infarction (STEMI).

Methods and Results

By searching PubMed, EMBASE, and the Cochrane Library (up to December 2012), seven randomized controlled trials (RCTs) reporting cardiac functional parameters with a total of 1,250 acute STEMI patients were identified. When applied to patients with acute STEMI, high-dose EPO was relatively safe and no increase in all-caused death and severe adverse effects were indicated. Estimates were pooled from fixed or random effects models. Compared with controls, high-dose EPO resulted in a slight but significant improvement in left ventricular ejection fraction of 1.02 % [95 % confidence interval (CI) 0.17–1.88, P = 0.019, I 2 = 0 %] and an improvement in left ventricular end-systolic volume of −4.61 ml (95 % CI −7.64 to −1.58, P = 0.003, I 2 = 27.7 %).

Conclusions

Available evidence suggested that high-dose EPO has limited cardio-protective effects in patients with STEMI. However, considering the relatively short follow-up durations and small patient populations in the current RCTs, the effects of high-dose EPO on clinical outcomes in patients with STEMI need to be evaluated in larger prospective RCTs of longer duration.

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Contributorship

Yanting Wen: assessment of original text; data collection; data analysis. Jingyan Xu: assessment of original text; data collection; data analysis. Xiaodong Ma: assessment of original text; data collection. Qian Gao: design; critical revision of article; approval of article.

Funding

This work was supported by the National Natural Science Foundation of China (81100386, 81030013), the New Teachers’ Fund for Doctor Stations, Ministry of Education of China (20110091120031) and the National Ministry of Science and Technology (2009CB918704).

Conflict of interest

The authors state no conflict of interest.

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Authors and Affiliations

  1. Center for Translational Medicine, Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, 22 Hankou Road, Nanjing, 210093, China

    Yanting Wen, Xiaodong Ma & Qian Gao

  2. Department of Hematology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China

    Jingyan Xu

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  1. Yanting Wen
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Correspondence to Qian Gao.

Additional information

Y. Wen and J. Xu contributed equally to this paper.

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Wen, Y., Xu, J., Ma, X. et al. High-Dose Erythropoietin in Acute ST-Segment Elevation Myocardial Infarction: A Meta-Analysis of Randomized Controlled Trials. Am J Cardiovasc Drugs 13, 435–442 (2013). https://doi.org/10.1007/s40256-013-0042-3

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