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A pilot study of chronic, low-dose epoetin-β following percutaneous coronary intervention suggests safety, feasibility, and efficacy in patients with symptomatic ischaemic heart failure

Item Type:Article
Title:A pilot study of chronic, low-dose epoetin-β following percutaneous coronary intervention suggests safety, feasibility, and efficacy in patients with symptomatic ischaemic heart failure
Creators Name:Bergmann, M.W. and Haufe, S. and von Knobelsdorff-Brenkenhoff, F. and Mehling, H. and Wassmuth, R. and Muench, I. and Busjahn, A. and Schulz-Menger, J. and Jordan, J. and Luft, F.C. and Dietz, R.
Abstract:AIMS: Low-dose epoetin-{beta} improved neo-angiogenesis and cardiac regeneration in experimental models of ischaemic cardiomyopathy without raising haemoglobin. No clinical study has tested this approach to date. METHODS AND RESULTS: We performed a randomized, placebo-controlled, double-blind, single-centre study of 35 IU/kg body weight epoetin-{beta} given subcutaneously once weekly for 6 months started within 3 weeks after successful percutaneous coronary intervention (PCI). Patients were included if they presented with a lesion within the proximal segment of the left anterior descending artery, the right coronary artery, or circumflex and had symptomatic heart failure. Patients with ST-segment elevation due to an acute myocardial infarct were excluded. The outcome variables were measured at baseline and at 6 months. Primary outcome measure was individual change in ejection fraction; secondary outcome was safety, change in N-terminal pro-brain natriuretic peptide, and peak VO(2). Twenty-four patients completed the 6-month treatment course. No adverse event related to the treatment occurred. Low-dose epoetin-{beta} following PCI significantly improved global ejection fraction as measured by echocardiography (EPO: {delta}EF 5.2 +/- 2.0%, P= 0.013; placebo: DeltaEF 0.3 +/- 1.6%, P= 0.851; P= 0.019 for the inter-group difference) and cardiac magnetic resonance (EPO: DeltaEF 3.1 +/- 1.6%, P= 0.124; placebo: -1.9 +/- 1.2%, P= 0.167; P= 0.042 for the inter-group difference). N-terminal pro-brain natriuretic peptide levels decreased in both groups without significant inter-group differences. Peak VO(2) levels increased significantly by 3.9 +/- 1.1% (P< 0.05) in the EPO group, whereas in the placebo group the increase did not reach statistical significance ({delta}peak VO(2) 3.0 +/- 1.6, P = ns). No significant difference regarding peak VO(2) was observed between the EPO and placebo groups. CONCLUSIONS: Low-dose epoetin-{beta} treatment following PCI is safe and feasible, and has possible beneficial effects on global ejection fraction and measures of exercise capacity. Extended low-dose epoetin-{beta} treatment warrants further mechanistic studies as well as larger clinical trials. Clinical Trial Registration Information: NCT00568542.
Keywords:Heart Failure, Growth Substances, Ischaemia
Source:European Journal of Heart Failure
ISSN:1388-9842
Publisher:Elsevier (The Netherlands)
Volume:13
Number:5
Page Range:560-568
Date:May 2011
Official Publication:https://doi.org/10.1093/eurjhf/hfr002
PubMed:View item in PubMed

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