The influence of Erythropoietin on platelet activation, thrombin generation and FVII/active FVII in patients with AMI

Thrombosis Journal

Ilka Ott²  Moshe Mittelman³  Mira Marcus-Kalish¹  Mark Roest⁶  Friedo Dekker⁴  Marit M Suttorp⁴  Tiny Hoekstra⁴  Armin Scherhag⁵  Magdalena Laux²  Gabriele Demetz² 

[1] Interdisciplinary Center for Technology Analysis & Forecasting (ICTAF), Tel Aviv University, Tel Aviv, 69978, Israel;Deutsches Herzzentrum der Technischen Universität München, Lazarettstr. 36, München, 80636, Germany;Department of Medicine A, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel;Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands;Pharmaceutical Division, F. Hoffmann–La Roche, Basel, Switzerland;Department of Clinical Chemistry and Haematology, University Medical Center, Utrecht, The Netherlands

关键词: PCI;    AMI;    Erythropoietin;    Platelet activation;   

Others  :  1132753
DOI  :  10.1186/1477-9560-12-18

 received in 2013-12-30, accepted in 2014-07-17,  发布年份 2014

【 摘 要 】

Background

Erythropoietin (Epo) has been shown to improve myocardial function in models of experimental myocardial infarction, but has also been associated with a rise in thromboembolic events. Thus, the aim of this study was to investigate the influence of Epo on platelet activation and coagulation in patients with acute myocardial infarction (AMI).

Methods

The study was designed as a substudy of the randomised, double-blind, placebo controlled REVIVAL-3 (REgeneration of VItal Myocardium in ST-Segment EleVation MyocardiAL Infarction byErythropoietin) study that investigated the effects of recombinant human Epo in AMI. Serial venous blood samples were collected before and after study medication. Circulating prothrombin fragment F1 + 2, FVII, active FVII, beta thromboglobulin (TG) and P-Selectin were measured before and 60 hours after randomization by immunoassay (n = 94). In a randomly selected subgroup platelet aggregation was measured using whole blood aggregometry (Multiplate Analyzer, n = 45).

Results

After 5 days an increase in FVII was observed after Epo as compared to placebo (P = 0.02), yet active FVII and prothrombin fragment F1 + 2 remained unchanged. Moreover, no statistically significant differences in circulating TG or P-selectin were observed between the groups. As an expected response to peri-interventional therapy with clopidogrel and aspirin, platelet aggregation after stimulation with ADP, TRAP, ASPI or collagen decreased 12 hours and 2 days after PCI. However, no difference between the Epo and the placebo group was observed.

Conclusion

After treatment with Epo in patients with AMI a slight increase in circulating FVII after Epo was not associated with an increase in active FVII, prothrombin fragment F1 + 2, TG or P-selectin. Moreover, platelet aggregation was not altered after treatment with Epo as compared to placebo.

Trial registration

ClinicalTrials.gov Identifier: NCT01761435

【 授权许可】

   
2014 Demetz et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

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