CLINICAL RESEARCH: MYOCARDIAL INFARCTION
High Serum Erythropoietin Level Is Associated With Smaller Infarct Size in Patients With Acute Myocardial Infarction Who Undergo Successful Primary Percutaneous Coronary Intervention
Shigeto Namiuchi, MD*,
Yutaka Kagaya, MD ,*,
Jun Ohta, MD,
Nobuyuki Shiba, MD,
Masafumi Sugi, MD*,
Masayoshi Oikawa, MD*,
Hiroyuki Kunii, MD*,
Hidetsugu Yamao, MD*,
Nobuo Komatsu, MD*,
Mitsuru Yui, MD*,
Hiroko Tada, MD,
Masahito Sakuma, MD,
Jun Watanabe, MD,
Toshikatsu Ichihara, MD* and
Kunio Shirato, MD
* Department of Cardiology, Iwaki Kyoritsu General Hospital, Iwaki, Japan
Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
Manuscript received December 13, 2004;
accepted January 5, 2005.
* Reprint requests and correspondence: Dr. Yutaka Kagaya, Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan (Email: kagaya{at}cardio.med.tohoku.ac.jp).
OBJECTIVES: We investigated whether a higher serum erythropoietin (EPO) level in patients with acute myocardial infarction (MI) subjected to successful primary percutaneous coronary intervention (PCI) can predict a smaller infarct size determined by creatine kinase (CK) release.
BACKGROUND: Erythropoietin has been shown to protect cardiomyocytes from ischemia-reperfusion injury in rodents.
METHODS: We prospectively studied 101 patients with first MI who received successful primary PCI within 12 h from the onset of MI. Blood samples were collected to examine the serum EPO level after the primary PCI and within 24 h from the onset of MI.
RESULTS: The peak CK level and cumulative CK release were significantly lower in the above-median EPO group than in the below-median EPO group. Thrombolysis In Myocardial Infarction (TIMI) grades and collateral grades before PCI, infarct-related coronary arteries, time to the successful reperfusion from the onset of MI, and serum creatinine levels were similar in the two EPO groups. A stepwise multiple regression analysis revealed that the absolute serum EPO level (mU/ml) as well as TIMI grades after PCI and preinfarction angina was an independent predictor for the cumulative CK release.
CONCLUSIONS: These data suggest that a high endogenous EPO level can predict a smaller infarct size in patients with acute MI subjected to successful primary PCI. This might be attributed to the potentially protective effect of endogenous EPO against ischemia-reperfusion injury in humans.
|
Abbreviations and Acronyms
| | BNP = brain natriuretic peptide | | CK = creatine kinase | | EPO = erythropoietin | | LV = left ventricle/ventricular | | MI = myocardial infarction | | PCI = percutaneous coronary intervention | | TIMI = Thrombolysis In Myocardial Infarction |
|
This article has been cited by other articles:
|
|
|
|
 
D. E. Burger, F.-L. Xiang, L. Hammoud, D. L. Jones, and Q. Feng
Erythropoietin Protects the Heart from Ventricular Arrhythmia during Ischemia and Reperfusion via Neuronal Nitric-Oxide Synthase
J. Pharmacol. Exp. Ther.,
June 1, 2009;
329(3):
900 - 907.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. D. Pagourelias, C. Koumaras, A. I. Kakafika, K. Tziomalos, P. G. Zorou, V. G. Athyros, and A. Karagiannis
Cardiorenal Anemia Syndrome: Do Erythropoietin and Iron Therapy Have a Place in the Treatment of Heart Failure?
Angiology,
February 1, 2009;
60(1):
74 - 81.
[Abstract]
[PDF]
|
|
|
|
|
|
|
D Mocini, P Muso, E Guendouz, L De Marco, L Mele, R Cini, P Sordini, A Alois, A Costantino, S Arima, et al.
Endogenous erythropoietin and a single bolus of 40,000 IU of epoetin alpha do not protect the heart from ischaemia-reperfusion injury during extracorporeal circulation for cardiac surgery
Perfusion,
May 1, 2008;
23(3):
187 - 192.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C. Casals-Pascual, R. Idro, N. Gicheru, S. Gwer, B. Kitsao, E. Gitau, R. Mwakesi, D. J. Roberts, and C. R. J. C. Newton
High levels of erythropoietin are associated with protection against neurological sequelae in African children with cerebral malaria
PNAS,
February 19, 2008;
105(7):
2634 - 2639.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. Husemann, M. Fobker, M. Pohlen, C. Bruch, M. Hausberg, G. Breithardt, and H. Reinecke
Impact of haemoglobin concentration and chronic kidney disease in patients with coronary heart disease undergoing percutaneous coronary interventions
Nephrol. Dial. Transplant.,
September 1, 2007;
22(9):
2563 - 2570.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Ferrario, M. Massa, V. Rosti, R. Campanelli, M. Ferlini, B. Marinoni, G. M. De Ferrari, V. Meli, M. De Amici, A. Repetto, et al.
Early haemoglobin-independent increase of plasma erythropoietin levels in patients with acute myocardial infarction
Eur. Heart J.,
August 1, 2007;
28(15):
1805 - 1813.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y. Asaumi, Y. Kagaya, M. Takeda, N. Yamaguchi, H. Tada, K. Ito, J. Ohta, T. Shiroto, K. Shirato, N. Minegishi, et al.
Protective Role of Endogenous Erythropoietin System in Nonhematopoietic Cells Against Pressure Overload-Induced Left Ventricular Dysfunction in Mice
Circulation,
April 17, 2007;
115(15):
2022 - 2032.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Nakano, K. Satoh, Y. Fukumoto, Y. Ito, Y. Kagaya, N. Ishii, K. Sugamura, and H. Shimokawa
Important Role of Erythropoietin Receptor to Promote VEGF Expression and Angiogenesis in Peripheral Ischemia in Mice
Circ. Res.,
March 16, 2007;
100(5):
662 - 669.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Lipsic, R. G. Schoemaker, P. van der Meer, A. A. Voors, D. J. van Veldhuisen, and W. H. van Gilst
Protective Effects of Erythropoietin in Cardiac Ischemia: From Bench to Bedside
J. Am. Coll. Cardiol.,
December 5, 2006;
48(11):
2161 - 2167.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. M. Davidson and D. M. Yellon
Dissecting out the mechanism of cardioprotection by endogenous erthyropoietin using genetic engineering
Cardiovasc Res,
August 1, 2006;
71(3):
408 - 410.
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Tada, Y. Kagaya, M. Takeda, J. Ohta, Y. Asaumi, K. Satoh, K. Ito, A. Karibe, K. Shirato, N. Minegishi, et al.
Endogenous erythropoietin system in non-hematopoietic lineage cells plays a protective role in myocardial ischemia/reperfusion
Cardiovasc Res,
August 1, 2006;
71(3):
466 - 477.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. R. Gross and G. J. Gross
Ligand triggers of classical preconditioning and postconditioning
Cardiovasc Res,
May 1, 2006;
70(2):
212 - 221.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Miki, T. Miura, T. Yano, A. Takahashi, J. Sakamoto, M. Tanno, H. Kobayashi, Y. Ikeda, M. Nishihara, K. Naitoh, et al.
Alteration in Erythropoietin-Induced Cardioprotective Signaling by Postinfarct Ventricular Remodeling
J. Pharmacol. Exp. Ther.,
April 1, 2006;
317(1):
68 - 75.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Satoh, Y. Kagaya, M. Nakano, Y. Ito, J. Ohta, H. Tada, A. Karibe, N. Minegishi, N. Suzuki, M. Yamamoto, et al.
Important Role of Endogenous Erythropoietin System in Recruitment of Endothelial Progenitor Cells in Hypoxia-Induced Pulmonary Hypertension in Mice
Circulation,
March 21, 2006;
113(11):
1442 - 1450.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Namiuchi and Y. Kagaya
Reply
J. Am. Coll. Cardiol.,
January 17, 2006;
47(2):
469 - 470.
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Lipsic, A. A. Voors, and D. J. van Veldhuisen
Serum Erythropoietin Levels and Infarct Size
J. Am. Coll. Cardiol.,
January 17, 2006;
47(2):
468 - 469.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. N. DeMaria, O. Ben-Yehuda, D. Berman, G. K. Feld, G. S. Ginsburg, B. H. Greenberg, W. Y.W. Lew, D. Sahn, and S. Tsimikas
Highlights of the Year in JACC 2005
J. Am. Coll. Cardiol.,
January 3, 2006;
47(1):
184 - 202.
[Full Text]
[PDF]
|
|
|
|
