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EPC mobilization after erythropoietin treatment in acute ST-elevation myocardial infarction: the REVEAL EPC substudy.

Publication ,  Journal Article
Povsic, TJ; Najjar, SS; Prather, K; Zhou, J; Adams, SD; Zavodni, KL; Kelly, F; Melton, LG; Hasselblad, V; Heitner, JF; Raman, SV; Barsness, GW ...
Published in: J Thromb Thrombolysis
November 2013

Erythropoietin (EPO) was hypothesized to mitigate reperfusion injury, in part via mobilization of endothelial progenitor cells (EPCs). The REVEAL trial found no reduction in infarct size with a single dose of EPO (60,000 U) in patients with ST-segment elevation myocardial infarction. In a substudy, we aimed to determine the feasibility of cryopreserving and centrally analyzing EPC levels to assess the relationship between EPC numbers, EPO administration, and infarct size. As a prespecified substudy, mononuclear cells were locally cryopreserved before as well as 24 and 48-72 h after primary percutaneous coronary intervention. EPC samples were collected in 163 of 222 enrolled patients. At least one sample was obtained from 125 patients, and all three time points were available in 83 patients. There were no significant differences in the absolute EPC numbers over time or between EPO- and placebo-treated patients; however, there was a trend toward a greater increase in EPC levels from 24 to 48-72 h postintervention in patients receiving ≥30,000 U of EPO (P = 0.099 for CD133(+) cells, 0.049 for CD34(+) cells, 0.099 for ALDH(br) cells). EPC numbers at baseline were inversely related to infarct size (P = 0.03 for CD133(+) cells, 0.006 for CD34(+) cells). Local whole cell cryopreservation and central EPC analysis in the context of a multicenter randomized trial is feasible but challenging. High-dose (≥30,000 U) EPO may mobilize EPCs at 48-72 h, and baseline EPC levels may be inversely associated with infarct size.

Duke Scholars

Published In

J Thromb Thrombolysis

DOI

EISSN

1573-742X

Publication Date

November 2013

Volume

36

Issue

4

Start / End Page

375 / 383

Location

Netherlands

Related Subject Headings

  • Stem Cells
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Leukocytes, Mononuclear
  • Leukocyte Count
  • Humans
  • Hematopoietic Stem Cell Mobilization
  • Female
  • Erythropoietin
 

Citation

APA
Chicago
ICMJE
MLA
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Povsic, T. J., Najjar, S. S., Prather, K., Zhou, J., Adams, S. D., Zavodni, K. L., … Rao, S. V. (2013). EPC mobilization after erythropoietin treatment in acute ST-elevation myocardial infarction: the REVEAL EPC substudy. J Thromb Thrombolysis, 36(4), 375–383. https://doi.org/10.1007/s11239-013-0944-6
Povsic, Thomas J., Samer S. Najjar, Kristi Prather, Jiying Zhou, Stacie D. Adams, Katherine L. Zavodni, Francine Kelly, et al. “EPC mobilization after erythropoietin treatment in acute ST-elevation myocardial infarction: the REVEAL EPC substudy.J Thromb Thrombolysis 36, no. 4 (November 2013): 375–83. https://doi.org/10.1007/s11239-013-0944-6.
Povsic TJ, Najjar SS, Prather K, Zhou J, Adams SD, Zavodni KL, et al. EPC mobilization after erythropoietin treatment in acute ST-elevation myocardial infarction: the REVEAL EPC substudy. J Thromb Thrombolysis. 2013 Nov;36(4):375–83.
Povsic, Thomas J., et al. “EPC mobilization after erythropoietin treatment in acute ST-elevation myocardial infarction: the REVEAL EPC substudy.J Thromb Thrombolysis, vol. 36, no. 4, Nov. 2013, pp. 375–83. Pubmed, doi:10.1007/s11239-013-0944-6.
Povsic TJ, Najjar SS, Prather K, Zhou J, Adams SD, Zavodni KL, Kelly F, Melton LG, Hasselblad V, Heitner JF, Raman SV, Barsness GW, Patel MR, Kim RJ, Lakatta EG, Harrington RA, Rao SV. EPC mobilization after erythropoietin treatment in acute ST-elevation myocardial infarction: the REVEAL EPC substudy. J Thromb Thrombolysis. 2013 Nov;36(4):375–383.
Journal cover image

Published In

J Thromb Thrombolysis

DOI

EISSN

1573-742X

Publication Date

November 2013

Volume

36

Issue

4

Start / End Page

375 / 383

Location

Netherlands

Related Subject Headings

  • Stem Cells
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Leukocytes, Mononuclear
  • Leukocyte Count
  • Humans
  • Hematopoietic Stem Cell Mobilization
  • Female
  • Erythropoietin