I have to say, the outcomes of this study both surprised and did not surprise me. A couple years ago, I read a few articles regarding erythropoietin administration in animal models of myocardial ischemia, and they actually tended towards cardioprotective effects. However, there have been some other retrospective reviews looking at erythropoietin levels in humans that have not been quite as conclusive.
The efficacy cohort rather favored the intervention group – the most important significant difference was primary vs. rescue PCI, and significantly more EPO group patients received primary PCI. But, then, their results section is mostly a long list of non-significant differences, and some secondary outcomes favoring placebo. Adverse events also favored placebo. So, I don’t think we’ll be seeing EPO on the code STEMI order sheet anytime soon.
As another aside, and sort of a follow-up to the Annals of Internal Medicine article a month ago regarding conflicts of interest in the new ACC Guidelines – the disclosure list for this article is massive. It is clearly the standard of care in Cardiology to be on the payroll of multiple pharmaceutical companies in one fashion or another.