Background: Erythropoietin (EPO) has been suggested to promote cardiac repair after MI. However, the\nrandomized, double-blind, placebo controlled REVIVAL-3 trial showed that short term high dose EPO in timely\nreperfused myocardium does not improve left ventricular ejection fraction after 6 months. Moreover, the study\nraised safety concerns due to a trend towards a higher incidence of adverse clinical events as well as a increase in\nneointima formation after treatment with EPO. The present study therefore aimed to assess the 5-year clinical\noutcomes.\nMethods: After successful reperfusion 138 patients with STEMI were randomly assigned to receive epoetin\nbeta (3.33Ã?â??104 U, n = 68) or placebo (n = 70) immediately, 24 and 48 h after percutaneous coronary intervention. The\nprimary outcome of the present study- the combined incidence of MACE 5 years after randomization - occurred in\n25% of the patients assigned to epoetin beta and 17% of the patients assigned to placebo (RR 1.5; 95% CI 0.8-3.5; p = 0.\n26). Target lesion revascularization was required in 15 patients (22.1%) treated with epoetin-Ã?Ÿ and 9 patients (12.9%)\ntreated with placebo (p = 0.15). Analysis of patients in the upper and lower quartile of baseline hemoglobin as an\nindirect estimate of endogenous erythropoietin levels revealed no significant impact of endogenous erythropoietin on\nefficiency of exogen administered epoetin-Ã?Ÿ in terms of death and MACE.\nConclusion: These long-term follow-up data show that epoetin beta does not improve clinical outcomes of patients\nwith acute myocardial infarction.
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