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

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Abstract

Purpose

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.

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Author information

Authors and Affiliations

  1. Department of Cardiology, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands

    Marieke L. Fokkema, Lennaert Kleijn, Peter van der Meer, Sandra K. Achterhof, Hans L. Hillege, Wiek H. van Gilst, Dirk J. van Veldhuisen & Adriaan A. Voors

  2. Athena Institute, VU University, Amsterdam, The Netherlands

    Anne M. Belonje

  3. Department of Cardiology, Isala Clinics, Zwolle, The Netherlands

    Arnoud van ’t Hof

  4. Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands

    J. Wouter Jukema

  5. Department of Cardiology, Medical Center Alkmaar, Alkmaar, The Netherlands

    Hans O. Peels

  6. Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands

    José P. Henriques

  7. Department of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands

    Jurriën M. ten Berg

  8. Department of Cardiology, Amphia Hospital, Breda, The Netherlands

    Jeroen Vos

Authors
  1. Marieke L. Fokkema
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  2. Lennaert Kleijn
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  3. Peter van der Meer
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  4. Anne M. Belonje
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  5. Sandra K. Achterhof
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  6. Hans L. Hillege
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  7. Arnoud van ’t Hof
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  8. J. Wouter Jukema
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  11. Jurriën M. ten Berg
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  12. Jeroen Vos
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  13. Wiek H. van Gilst
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  14. Dirk J. van Veldhuisen
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  15. Adriaan A. Voors
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Corresponding author

Correspondence to Adriaan A. Voors.

Additional information

Marieke L. Fokkema and Lennaert Kleijn contributed equally.

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Fokkema, M.L., Kleijn, L., van der Meer, P. et al. Long Term Effects of Epoetin Alfa in Patients with ST- Elevation Myocardial Infarction. Cardiovasc Drugs Ther 27, 433–439 (2013). https://doi.org/10.1007/s10557-013-6470-0

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  • DOI: https://doi.org/10.1007/s10557-013-6470-0

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