Center for Translational Medicine, Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, 22 Hankou Road, Nanjing, 210093, China.
Am J Cardiovasc Drugs. 2013 Dec;13(6):435-42. doi: 10.1007/s40256-013-0042-3.
We sought to perform a meta-analysis to evaluate the potential influence of high-dose erythropoietin (EPO) on cardiac function parameters in patients with acute ST-segment elevation myocardial infarction (STEMI).
By searching PubMed, EMBASE, and the Cochrane Library (up to December 2012), seven randomized controlled trials (RCTs) reporting cardiac functional parameters with a total of 1,250 acute STEMI patients were identified. When applied to patients with acute STEMI, high-dose EPO was relatively safe and no increase in all-caused death and severe adverse effects were indicated. Estimates were pooled from fixed or random effects models. Compared with controls, high-dose EPO resulted in a slight but significant improvement in left ventricular ejection fraction of 1.02 % [95 % confidence interval (CI) 0.17-1.88, P = 0.019, I (2) = 0 %] and an improvement in left ventricular end-systolic volume of -4.61 ml (95 % CI -7.64 to -1.58, P = 0.003, I (2) = 27.7 %).
Available evidence suggested that high-dose EPO has limited cardio-protective effects in patients with STEMI. However, considering the relatively short follow-up durations and small patient populations in the current RCTs, the effects of high-dose EPO on clinical outcomes in patients with STEMI need to be evaluated in larger prospective RCTs of longer duration.
我们旨在进行一项荟萃分析，以评估大剂量促红细胞生成素（EPO）对急性 ST 段抬高型心肌梗死（STEMI）患者心功能参数的潜在影响。
通过检索 PubMed、EMBASE 和 Cochrane 图书馆（截至 2012 年 12 月），我们确定了 7 项报告心功能参数的随机对照试验（RCT），共纳入 1250 例急性 STEMI 患者。在急性 STEMI 患者中应用大剂量 EPO 相对安全，并未增加全因死亡和严重不良事件。采用固定或随机效应模型进行估计。与对照组相比，大剂量 EPO 可使左心室射血分数略有但显著改善 1.02% [95%置信区间（CI）0.17-1.88，P=0.019，I (2) =0%]，左心室收缩末期容积改善-4.61ml（95%CI -7.64 至-1.58，P=0.003，I (2) =27.7%）。
现有证据表明，大剂量 EPO 对 STEMI 患者具有有限的心脏保护作用。然而，鉴于当前 RCT 随访时间相对较短且患者人群较小，大剂量 EPO 对 STEMI 患者临床结局的影响需要在随访时间更长的更大规模前瞻性 RCT 中进行评估。
