Abstract
Background Erythropoiesis-stimulating agents (ESAs) have been investigated in small studies in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Erythropoiesis-stimulating agents did not show a clear effect on left ventricular function or clinical outcome, but some studies suggested an increased risk of thromboembolic events. Methods A systematic literature search in MEDLINE was performed, until December 2012. We included randomized clinical trials investigating the effect of ESAs in STEMI patients undergoing primary PCI, with ≥ 30 days of follow-up. The primary end point was a composite of all-cause mortality, myocardial infarction, and stent thrombosis after PCI. Secondary end point was all-cause mortality. Results Individual patient data were obtained from 10 of 11 trials, including 97.3% (1,242/1,277) of all patients randomized to control (n = 600) or to ESAs (n = 642). Baseline characteristics were well balanced between the treatment allocations. Mean follow-up time was 248 (±131) days. The primary end point occurred in 3.5% (20/577) in the control group and in 2.1% (13/610) in the ESA group (hazard ratio for ESAs, 0.63; 95% CI [0.31-1.27]; P =.20). Mortality occurred in 13 (2.3%) in the control group and 5 (0.8%) in the ESA group (hazard ratio for ESAs, 0.38; 95% CI [0.13-1.06]; P =.06). Conclusions Erythropoiesis-stimulating agent administration does not result in an increased risk of adverse cardiac events in STEMI patients undergoing primary PCI. Results of ongoing studies may provide further insight to the potential beneficial clinical effects of ESAs in STEMI patients.
| Original language | English |
|---|---|
| Journal | American Heart Journal |
| Volume | 168 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2014 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
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Safety and clinical outcome of erythropoiesis-stimulating agents in patients with ST-elevation myocardial infarction : A meta-analysis of individual patient data. / Fokkema, Marieke L.; Van Der Meer, Peter; Rao, Sunil V.; Belonje, Anne M.; Ferrario, Maurizio; Hillege, Hans L.; Katz, Stuart D.; Lipšic, Erik; Ludman, Andrew J.; Ott, Ilka; Prunier, Fabrice; Choi, Dong Ju; Toba, Ken; Van Veldhuisen, Dirk J.; Voors, Adriaan A.
In: American Heart Journal, Vol. 168, No. 3, 2014.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Safety and clinical outcome of erythropoiesis-stimulating agents in patients with ST-elevation myocardial infarction
T2 - A meta-analysis of individual patient data
AU - Fokkema, Marieke L.
AU - Van Der Meer, Peter
AU - Rao, Sunil V.
AU - Belonje, Anne M.
AU - Ferrario, Maurizio
AU - Hillege, Hans L.
AU - Katz, Stuart D.
AU - Lipšic, Erik
AU - Ludman, Andrew J.
AU - Ott, Ilka
AU - Prunier, Fabrice
AU - Choi, Dong Ju
AU - Toba, Ken
AU - Van Veldhuisen, Dirk J.
AU - Voors, Adriaan A.
PY - 2014
Y1 - 2014
N2 - Background Erythropoiesis-stimulating agents (ESAs) have been investigated in small studies in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Erythropoiesis-stimulating agents did not show a clear effect on left ventricular function or clinical outcome, but some studies suggested an increased risk of thromboembolic events. Methods A systematic literature search in MEDLINE was performed, until December 2012. We included randomized clinical trials investigating the effect of ESAs in STEMI patients undergoing primary PCI, with ≥ 30 days of follow-up. The primary end point was a composite of all-cause mortality, myocardial infarction, and stent thrombosis after PCI. Secondary end point was all-cause mortality. Results Individual patient data were obtained from 10 of 11 trials, including 97.3% (1,242/1,277) of all patients randomized to control (n = 600) or to ESAs (n = 642). Baseline characteristics were well balanced between the treatment allocations. Mean follow-up time was 248 (±131) days. The primary end point occurred in 3.5% (20/577) in the control group and in 2.1% (13/610) in the ESA group (hazard ratio for ESAs, 0.63; 95% CI [0.31-1.27]; P =.20). Mortality occurred in 13 (2.3%) in the control group and 5 (0.8%) in the ESA group (hazard ratio for ESAs, 0.38; 95% CI [0.13-1.06]; P =.06). Conclusions Erythropoiesis-stimulating agent administration does not result in an increased risk of adverse cardiac events in STEMI patients undergoing primary PCI. Results of ongoing studies may provide further insight to the potential beneficial clinical effects of ESAs in STEMI patients.
AB - Background Erythropoiesis-stimulating agents (ESAs) have been investigated in small studies in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Erythropoiesis-stimulating agents did not show a clear effect on left ventricular function or clinical outcome, but some studies suggested an increased risk of thromboembolic events. Methods A systematic literature search in MEDLINE was performed, until December 2012. We included randomized clinical trials investigating the effect of ESAs in STEMI patients undergoing primary PCI, with ≥ 30 days of follow-up. The primary end point was a composite of all-cause mortality, myocardial infarction, and stent thrombosis after PCI. Secondary end point was all-cause mortality. Results Individual patient data were obtained from 10 of 11 trials, including 97.3% (1,242/1,277) of all patients randomized to control (n = 600) or to ESAs (n = 642). Baseline characteristics were well balanced between the treatment allocations. Mean follow-up time was 248 (±131) days. The primary end point occurred in 3.5% (20/577) in the control group and in 2.1% (13/610) in the ESA group (hazard ratio for ESAs, 0.63; 95% CI [0.31-1.27]; P =.20). Mortality occurred in 13 (2.3%) in the control group and 5 (0.8%) in the ESA group (hazard ratio for ESAs, 0.38; 95% CI [0.13-1.06]; P =.06). Conclusions Erythropoiesis-stimulating agent administration does not result in an increased risk of adverse cardiac events in STEMI patients undergoing primary PCI. Results of ongoing studies may provide further insight to the potential beneficial clinical effects of ESAs in STEMI patients.
UR - http://www.scopus.com/inward/record.url?scp=84908540058&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84908540058&partnerID=8YFLogxK
U2 - 10.1016/j.ahj.2014.04.020
DO - 10.1016/j.ahj.2014.04.020
M3 - Article
C2 - 25173548
AN - SCOPUS:84908540058
VL - 168
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
IS - 3
ER -