AHA: Single Epoetin Alfa Infusion May Not Help in STEMI

Does not reduce infarct size; increases number of adverse cardiac events

TUESDAY, Nov. 16 (HealthDay News) -- A single infusion of epoetin alfa in patients with ST-segment elevation myocardial infarction (STEMI) who undergo successful percutaneous coronary intervention (PCI) appears to provide more harm than benefit, according to a study presented at the American Heart Association's Scientific Sessions 2010, held from Nov. 13 to 17 in Chicago.

Sunil V. Rao, M.D., of the Duke Clinical Research Institute in Durham, N.C., and colleagues randomized 136 patients with STEMI who underwent successful PCI within eight hours of symptom onset to 60,000 units of intravenous epoetin alfa or matching saline placebo given within four hours of reperfusion.

The investigators found that infarct size did not differ between those who were administered epoetin alfa and those who received placebo at two to six days after medication administration or at three months after administration. In those older than 70, infarct size in the first week was bigger in the epoetin alfa group. Compared to those who received placebo, patients who received epoetin alfa had a higher incidence of death, myocardial infarction, stroke or stent thrombosis (4 versus 0 percent).

"A single infusion of epoetin alfa in patients with STEMI who were successfully reperfused did not reduce infarct size, and may increase infarct size and major adverse cardiac events in older patients," the authors write.

One author disclosed a financial relationship with Heart IT Technologies.

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