losartan-potassium and ST-Elevation-Myocardial-Infarction

To investigate the effects of erythropoietin (EPO) on the clinical outcomes of patients with acute ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI).. We collected randomized controlled studies conducted before April 15, 2017, and performed a meta-analysis using RevMan5.3 software.. Compared with the conventional revascularization group, mortality (RR = 0.79; 95% Cl, 0.42 - 1.50; p = 0.47), stroke events (RR = 2.63; 95% Cl, 0.70 - 9.85; p = 0.15), recurrent myocardial infarction (RR = 0.99; 95% Cl, 0.44 - 2.20; p = 0.98), and other clinical endpoints were not significantly different in the EPO group. However, subgroup analysis showed a marginally significant difference between the high-dose EPO group and the control group (MD = 1.29; 95% CI, 0.02 - 2.56; p = 0.05) in ejection fraction.. The administration of EPO has no effects on the clinical outcomes of patients with acute STEMI after PCI, whilst a high dose of EPO may increase patients' ejection fraction.
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Topics: Erythropoietin; Humans; Percutaneous Coronary Intervention; ST Elevation Myocardial Infarction; Stroke Volume

Erythropoietin (EPO) has antiapoptotic and tissue-protective effects, but previous clinical studies using high-dose EPO have not shown cardioprotective effects, probably because of platelet activation and a lack of knowledge regarding the optimal dose. In contrast, a small pilot study using low-dose EPO has shown improvement in left ventricular function without adverse cardiovascular events.Methods and Results:We performed a multicenter (25 hospitals), prospective, randomized, double-blind, placebo-controlled, dose-finding study to clarify the efficacy and safety of low-dose EPO in patients with ST-segment elevation myocardial infarction (STEMI) under the Evaluation System of Investigational Medical Care of the Ministry of Health, Labor and Welfare of Japan. In total, 198 STEMI patients with low left ventricular ejection fraction (LVEF <50%) were randomly assigned to receive intravenous administration of EPO (6,000 or 12,000 IU) or placebo within 6 h of successful percutaneous coronary intervention. At 6 months, there was no significant dose-response relationship in LVEF improvement among the 3 groups tested (EPO 12,000 IU: 5.4±9.3%, EPO 6,000 IU: 7.3±7.7%, Placebo: 8.1±8.3%, P=0.862). Low-dose EPO also did not improve cardiac function, as evaluated by. Administration of low-dose EPO did not improve LVEF at 6 months in STEMI patients (UMIN000005721).

Topics: Aged; Dose-Response Relationship, Drug; Erythropoietin; Female; Humans; Japan; Male; Middle Aged; Pilot Projects; ST Elevation Myocardial Infarction; Stroke Volume; Treatment Failure; Ventricular Function, Left

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 (3.33×10. 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.

Topics: Coronary Angiography; Dose-Response Relationship, Drug; Double-Blind Method; Erythropoietin; Female; Follow-Up Studies; Germany; Humans; Injections, Intravenous; Male; Middle Aged; Percutaneous Coronary Intervention; Postoperative Care; Prospective Studies; Recombinant Proteins; ST Elevation Myocardial Infarction; Survival Rate; Time Factors; Treatment Outcome