Gholamzadeh Ali, Amini Sara, Mohammadpour Amir H, Vahabzadeh Maryam, Fazelifar Amir F, Fazlinezhad Afsoon, Dehghani Mashalla, Moohebati Mohsen, Dastani Mostafa, Malaekeh-Nikouie Bizhan, Falsoleiman Homa
*Department of Pharmaceutical Science, Faculty of Pharmacy, Mashhad University of Medical Science, Mashhad, Iran; †Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran; ‡Department of Pharmacodynamics and Toxicology, Faculty of Pharmacy, Mashhad University of Medical Science, Mashhad, Iran; and §Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran.
J Cardiovasc Pharmacol. 2015 Jun;65(6):555-61. doi: 10.1097/FJC.0000000000000223.
Arrhythmia is the foremost cause of sudden death after myocardial infarction (MI). Animal models have recently shown that erythropoietin (EPO) can reduce the incidence of arrhythmia after MI.
We investigated the effects of administrating 33,000 IU EPO on the occurrence of post-MI arrhythmia in 40 patients with ST-elevation MI who were randomly assigned in either EPO or placebo groups. Arrhythmias were blindly documented using full 12-lead configuration during 24 hours after percutaneous coronary intervention (PCI) by a cardiologist. Afterward, CK-MB, hematologic, and hemodynamic data were examined within 2 weeks after MI.
A comparison made between the 2 groups showed significant differences in the incidence of arrhythmias (20% in EPO group and 35% in placebo group, P = 0.043). However, no significant differences in type of arrhythmias were observed between the groups. There was no significant difference between levels of CK-MB in the 2 groups during 24 hours (P = 0.186). Hematologic and hemodynamic data showed no significant changes 2 weeks after PCI.
High-dose administration of EPO in patients with ST-elevation MI who have been treated by primary PCI and standard antiplatelet therapy reduces the occurrence of arrhythmias. For clinical interpretation of the results, further well-designed trials are required.
心律失常是心肌梗死（MI）后猝死的首要原因。动物模型最近显示，促红细胞生成素（EPO）可降低MI后心律失常的发生率。
我们研究了对40例ST段抬高型MI患者给予33,000 IU EPO对MI后心律失常发生情况的影响，这些患者被随机分配到EPO组或安慰剂组。在经皮冠状动脉介入治疗（PCI）后24小时内，由心脏病专家使用完整的12导联配置盲目记录心律失常情况。之后，在MI后2周内检查肌酸激酶同工酶（CK-MB）、血液学和血流动力学数据。
两组之间的比较显示，心律失常发生率存在显著差异（EPO组为20%，安慰剂组为35%，P = 0.043）。然而，两组之间心律失常类型无显著差异。两组在24小时内CK-MB水平无显著差异（P = 0.186）。PCI后2周血液学和血流动力学数据无显著变化。
在接受直接PCI和标准抗血小板治疗的ST段抬高型MI患者中，高剂量给予EPO可减少心律失常的发生。为对结果进行临床解读，需要进一步设计完善的试验。
