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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

View larger version (20K): [in a new window]   Figure 1 Peak creatine kinase (CK) and cumulative CK release in the below-median (low erythropoietin [EPO], n = 52) and above-median (high EPO, n = 49) EPO groups. Mean ± SD.

View larger version (25K): [in a new window]   Figure 2 The relationship between the log serum erythropoietin (EPO) level and cumulative creatine kinase (CK) release in all the 101 patients enrolled in the present study. It is obvious that the patients with the higher cumulative CK release are located more frequently at the lower serum EPO level side than at the higher serum EPO level side, although the correlation between the two parameters is not strong.

View larger version (22K): [in a new window]   Figure 3 Results of left heart catheterization and left ventriculography. These measurements were performed according to the agreement of the patients as well as the decision by physicians (see Methods section). Each parameter was obtained from 38 patients in the below-median erythropoietin (EPO) (low EPO) group and 39 patients in the above-median EPO (high EPO) group immediately after the successful primary PCI. Mean ± SD. LV = left ventricular.

View larger version (14K): [in a new window]   Figure 4 The time course of the serum erythropoietin (EPO) levels in an additional study in which 18 patients with acute myocardial infarction (MI) who satisfied the inclusion criteria of the present study were investigated. The blood sampling was performed soon after the primary percutaneous coronary intervention, and 24 h, 48 h, and 14 days after the onset of acute MI. Two-way analysis of variance with repeated measures revealed that the serum EPO level during the 14 days was significantly higher in the patients with an initial serum EPO level >20.3 mU/ml (n = 10) than in those with an initial serum EPO level <20.3 mU/ml (n = 8, p = 0.001). The interaction between the difference in the initial serum EPO levels and the time course of the serum EPO level was not statistically significant (p = 0.21). Mean ± SD. Solid triangles = initial EPO <20.3 mU/ml; open circles = initial EPO >20.3 mU/ml.