Effect of Erythropoietin in patients with acute myocardial infarction: five-year results of the REVIVAL-3 trial

Steppich, Birgit; Groha, Philipp; Ibrahim, Tareq; Schunkert, Heribert; Laugwitz, Karl‐Ludwig; Hadamitzky, Martin; Kastrati, Adnan; Ott, Ilka

doi:10.1186/s12872-016-0464-3

Cited by 19 publications

(16 citation statements)

References 40 publications

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“…However, further studies are required to explore the effect of the magnitude of anemia on mortality risk because therapy aimed at regulating hemoglobin level has failed to demonstrate clinical benefit. 17 Our study showed that increased BMI was associated with lower mortality risk. Although obesity is a well-established risk factor for cardiovascular disease, overweight or obese patients with AMI had lower short-and long-term mortality risk than normal weight patients, a phenomenon known as the "obesity paradox".…”

Section: Discussionmentioning

confidence: 54%

A Practical Risk Score to Predict 24-Month Post-Discharge Mortality Risk in Patients With Non-ST-Segment Elevation Myocardial Infarction

Fu¹,

Song²,

Yang³

et al. 2020

Circ J

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in the context of acute coronary syndrome (ACS), including TIMI score, 4 GRACE score, 5 ACTION score, 6 Canada Acute Coronary Syndrome risk score, 7 and TRS-2P score. 8 These scores focus on risk prediction in the acute phase of AMI (i.e., the risk of death within the first year after discharge). However, patients who survive AMI still have a high risk of adverse cardiovascular events beyond the first year. 9 The objective of our study was to develop and validate a risk score to predict long-term risk in patients who survive NSTEMI. Methods CAMI RegistryA detailed description of the CAMI registry was reported T he number of patients surviving acute myocardial infarction (AMI) has increased in recent years 1 due to advances in early diagnosis and improved treatment. 2 However, survivors of AMI have varying risk of recurrent cardiovascular events. 2 AMI is most commonly classified as ST-elevation MI (STEMI) or non-STEMI (NSTEMI) based on ECG characteristics. Compared with patients with STEMI, those with NSTEMI display worse long-term clinical outcomes. 3 Accurate risk stratification, particular among patients with NSTEMI, may assist in identifying those at high risk of future adverse cardiac events and who may benefit from intensive secondary prevention to improve outcomes.Several scores have been developed to predict prognosis

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Section: Discussionmentioning

confidence: 54%

A Practical Risk Score to Predict 24-Month Post-Discharge Mortality Risk in Patients With Non-ST-Segment Elevation Myocardial Infarction

Fu¹,

Song²,

Yang³

et al. 2020

Circ J

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“…Even though both mild and moderate to severe anemia did predict an increased risk for long-term mortality independent of a number of confounders in our study population, treatment strategies that aim at increasing Hb concentration in patients with AMI and anemia might not significantly benefit long-term survival. In line, a recent randomized controlled trial demonstrated that administering erythropoietin after PCI, a hypoxia-induced hormone that also regulates Hb concentration, did not have beneficial effects on long-term outcomes [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Association between admission anemia and long-term mortality in patients with acute myocardial infarction: results from the MONICA/KORA myocardial infarction registry

Colombo

Kirchberger

Amann

et al. 2018

BMC Cardiovasc Disord

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BackgroundPrevious studies have shown that the presence of anemia is associated with increased short- and long-term outcomes in patients with acute myocardial infarction (AMI). This study aims at examining the impact of admission anemia on long-term, all-cause mortality following AMI in patients recruited from a population-based registry. Contrary to most prior studies, we distinguished between patients with mild and moderate to severe anemia.MethodsThis prospective study was conducted in 2011 patients consecutively hospitalized for AMI that occurred between January 2005 and December 2008. Patients who survived more than 28 days after AMI were followed up until December 2011. Hemoglobin (Hb) concentration was measured at hospital admission and classified according to the World Health Organization (WHO). Mild anemia was defined as Hb concentration of 11 to < 12 g/dL in women and 11 to < 13 g/dL in men; moderate to severe anemia as Hb concentration of < 11 g/dL. Adjusted Cox regression models were calculated to compare survival in patients with and without anemia.ResultsMild anemia and moderate to severe anemia was found in 183 (9.1%) and 100 (5%) patients, respectively. All-cause mortality after a median follow-up time of 4.2 years was 11.9%. The Cox regression analysis showed significantly increased mortality risks in both patients with mild (HR 1.74, 95% CI 1.23–2.45) and moderate to severe anemia (HR 2.05, 95% CI 1.37–3.05) compared to patients without anemia.ConclusionThis study shows that anemia adversely affects long-term survival following AMI. However, further studies are needed to confirm that anemia can solely explain worse long-term outcomes after AMI.Electronic supplementary materialThe online version of this article (10.1186/s12872-018-0785-5) contains supplementary material, which is available to authorized users.

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“…Although consistent results in small rodents indicated erythropoietin as useful in reducing the myocardial infarction area and promoting cardiac repair (156), human studies didn't confirm these effects. The issue seems to be the timing of erythropoietin administration (157) and also with the adverse events.…”

Section: Erythropoietinmentioning

confidence: 99%

Getting an Early Start in Understanding Perinatal Asphyxia Impact on the Cardiovascular System

et al. 2020

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Perinatal asphyxia (PA) is a burdening pathology with high short-term mortality and severe long-term consequences. Its incidence, reaching as high as 10 cases per 1000 live births in the less developed countries, prompts the need for better awareness and prevention of cases at risk, together with management by easily applicable protocols. PA acts first and foremost on the nervous tissue, but also on the heart, by hypoxia and subsequent ischemia-reperfusion injury. Myocardial development at birth is still incomplete and cannot adequately respond to this aggression. Cardiac dysfunction, including low ventricular output, bradycardia, and pulmonary hypertension, complicates the already compromised circulatory status of the newborn with PA. Multiorgan and especially cardiovascular failure seem to play a crucial role in the secondary phase of hypoxic-ischemic encephalopathy (HIE) and its high mortality rate. Hypothermia is an acceptable solution for HIE, but there is a fragile equilibrium between therapeutic gain and cardiovascular instability. A profound understanding of the underlying mechanisms of the nervous and cardiovascular systems and a close collaboration between the bench and bedside specialists in these domains is compulsory. More resources need to be directed toward the prevention of PA and the consecutive decrease of cardiovascular dysfunction. Not much can be done in case of an unexpected acute event that produces PA, where recognition and prompt delivery are the key factors for a positive clinical result. However, the situation is different for high-risk pregnancies or circumstances that make the fetus more vulnerable to asphyxia. Improving the outcome in these cases is possible through careful monitoring, identifying the high-risk pregnancies, and the implementation of novel prenatal strategies. Also, apart from adequately supporting the heart through the acute episode, there is a need for protocols for long-term cardiovascular follow-up. This will increase our recognition of any lasting myocardial damage and will enhance our perspective on the real impact of PA. The goal of this article is to review data on the cardiovascular consequences of PA, in the context of an immature cardiovascular system, discuss the potential contribution of cardiovascular impairment on short and long-term outcomes, and propose further directions of research in this field.

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Effect of Erythropoietin in patients with acute myocardial infarction: five-year results of the REVIVAL-3 trial

Cited by 19 publications

References 40 publications

A Practical Risk Score to Predict 24-Month Post-Discharge Mortality Risk in Patients With Non-ST-Segment Elevation Myocardial Infarction

A Practical Risk Score to Predict 24-Month Post-Discharge Mortality Risk in Patients With Non-ST-Segment Elevation Myocardial Infarction

Association between admission anemia and long-term mortality in patients with acute myocardial infarction: results from the MONICA/KORA myocardial infarction registry

Getting an Early Start in Understanding Perinatal Asphyxia Impact on the Cardiovascular System

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