Long term effects of epoetin alfa in patients with ST-elevation myocardial infarction.

M.L. fokkema, L. Kleijn, P. van der Meer, A.M.S. Belonje, S.K. Achterhof, H.L. Hillege, A.W.J. van't Hof, J.W. Jukema, H.O. Peels, J.P. Henriques, J.M. ten Berg, J. Vos, W.H. van Gilst, D.J. van Veldhuisen, A.A. Voors

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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. © 2013 Springer Science+Business Media New York.
Original languageEnglish
JournalCardiovascular Drugs and Therapy
Volume27
Issue number5
DOIs
Publication statusPublished - 2013

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    fokkema, M. L., Kleijn, L., van der Meer, P., Belonje, A. M. S., Achterhof, S. K., Hillege, H. L., ... Voors, A. A. (2013). Long term effects of epoetin alfa in patients with ST-elevation myocardial infarction. Cardiovascular Drugs and Therapy, 27(5). https://doi.org/10.1007/s10557-013-6470-0