{"id":8221,"date":"2011-05-10T16:26:00","date_gmt":"2011-05-10T20:26:00","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?p=8221"},"modified":"2011-07-19T17:44:25","modified_gmt":"2011-07-19T21:44:25","slug":"trial-reveals-no-benefit-and-some-concerns-with-erythropoietin-after-primary-pci","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2011\/05\/10\/trial-reveals-no-benefit-and-some-concerns-with-erythropoietin-after-primary-pci\/","title":{"rendered":"Trial REVEALs No Benefit and Some Concerns with Erythropoietin After Primary PCI"},"content":{"rendered":"<p>Erythropoietin alfa failed to reduce infarct size and was associated  with more cardiovascular events when given after successful PCI in STEMI  patients, according to results from the <a href=\"http:\/\/jama.ama-assn.org\/content\/305\/18\/1863.full\">REVEAL (Reduction of Infarct  Expansion and Ventricular Remodeling With Erythropoietin After Large  Myocardial Infarction) trial published in<em> JAMA<\/em><\/a>.<\/p>\n<p>In the trial, which included a dose-escalation safety phase and a single-dose efficacy  phase, 222 patients at 28 sites in the U.S. were randomized to epoetin  alfa or placebo following successful reperfusion. Overall, there was no  difference between the groups in infarct size as assessed by MRI. However, among patients 70 years of age  or older (a prespecified subgroup), infarct size in the first week was significantly greater with treatment than with placebo: 19.9% versus 11.7% LV mass (p=0.03).<\/p>\n<p>During  the safety phase of the study, the composite endpoint of death, MI,  stroke, or stent thrombosis occurred in 5 of the 125 patients in the  treatment group compared with none of the 97 patients in the placebo group  (p=0.04).<\/p>\n<p>In <a href=\"http:\/\/jama.ama-assn.org\/content\/305\/18\/1908.extract\">an accompanying editorial<\/a>, Deepak Bhatt writes that  the results &#8220;raise further questions about the safety of epoetin alfa in  the context of acute MI.&#8221; He continues:<\/p>\n<p style=\"padding-left: 30px;\">&#8220;The totality of evidence strongly  suggests that this class of medication has cardiovascular risk, most  likely to manifest in higher-risk individuals. Until compelling data  become available to support routine use of these agents in patients with  anemia, it would be prudent to minimize their use, especially for  patients at high risk for cardiovascular disease or with an acute  ischemic syndrome.&#8221;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Erythropoietin alfa failed to reduce infarct size and was associated with more cardiovascular events when given after successful PCI in STEMI patients, according to results from the REVEAL (Reduction of Infarct Expansion and Ventricular Remodeling With Erythropoietin After Large Myocardial Infarction) trial published in JAMA. In the trial, which included a dose-escalation safety phase and [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[839,245],"class_list":["post-8221","post","type-post","status-publish","format-standard","hentry","category-interventional-cardiology","tag-erythropoietin-alfa","tag-mi"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/8221","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=8221"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/8221\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=8221"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=8221"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=8221"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}