Author/Editor		Strnad, Matej; Zadel, Sabina; Prosen, Gregor; Križmarić, Miljenko; Klemenc-Ketiš, Zalika
Title		Vpliv eritropoetina na velikost miokardnega infarkta pri bolnikih, ki so utrpeli srčni zastoj izven bolnišnice
Translated title		Impact of erythropoietin on myocardial infarction size in patients with out-of-hospital cardiac arrest due to acute myocardial infarction
Type		članek
Source		In: Gričar M, Vajd R, editors. Urgentna medicina: izbrana poglavja 2012. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		2012
Volume		str. 249-51
Language		slo
Abstract		Background: Erythropoietin (EPO) activates potent protective mechanisms in non-hematopoietic tissues including the myocardium. Administration of a singledose of exogenous EPO In animal models of ischaemia reperfusion injury is associated with reduced infarct size, suppressed ventricular remodeling andimproved cardiac contractility. Aim of the study:To investigate the effectsof intravenous p0 given during cardiopulmonary resuscitation (CPR) on the myocardial infarction size measured by serial troponin I levels (Tnl) and left ventricular ejection fraction (LVEF) in patients with out-of-hospital cardiac arrests (OHCA) due to acute myocardial infarction (AMI). Methods: Retrospective comparison was made between patients with OHCA due to AMI who were reated with EPO during CPR (90,000 IU of beta-epoetin, n = 11) with patients with OHCA due to AMI eated with 0.9% NaCI (control group = 6). Results: Compared with controls, myocardial infarct size measured by Tnl levels was slightly smaller in the EPO group (median values [IQR]; Tnl levels after 6 hours: 26[6-86] vs. 67[21-100] ng/l, p=0,368; Tni levels after 12 hours: 39[10-86] vs. 45[12-84] sag/1, p=1,000;Tnl levels after 24 hours: 21 [16-98] vs. 23[4-84] (jg/l, p=0,635), although these differences did not reachstatistical significance. LVEF was not statistically different between EPO group and control group (median values [IQR]; 47 [40-59] % vs. 50 [25-52] %; p= 0,524). Conclusions: A single high dose of EPO during CPR does not reduce myocardial infarction size and does not improve LVEF in patients with out-of-hospital cardiac arrest due to AMI.
Summary		Uvod: Eritropoetin (EPO) deluje zaščitno na miokard z zmanjševanjem reperfuzijske poškodbe, z zaviranjem apoptoze in vnetja, ter kasneje s spodbujanjem neovaskularizacije in preprečevanjem remodelacije miokarda po infarktu. Do sedaj je bilo opravljenih nekaj študij, kjer so ugotavljali vplivEPO na velikost miokardnega infarkta in njihovi zaključki so si nasprotujoči. Metode: Opravili smo retrospektivno analizo iz naše baze podatkov. Primerjali smo skupino bolnikov, ki so utrpeli srčni zastoj izven bolnišnice zaradi akutnega miokardnega infarkta (AMI) in smo jih oživljali terso med oživljanjem prejeli 90.000 IU EPO (EPO skupina; n=11), s skupino bolnikov s srčnim zastojem izven bolnišnice zaradi AMI, ki med oživljanjem niso prejeli EPO (kontrolna skupina; n=6). Primerjali smo raven serumske koncentracije troponina I (Tnl) 6 ur, 12 ur in 24 ur po sprejemu v bolnišnico in iztisni delež (ejekcijsko frakcijo) levega prekata (left ventricular ejection fraction,LVEF). Rezultati: Velikost miokardnega infarkta merjenega s serumsko ravnjo Tnl je v EPO skupini manjši, vendar ne dosega statistično značilne razlike: (srednja vrednost [IQR]; raven Tnl po 6 urah: 26[6-86] vs. 67[21-100] |jg/L p=0,368; raven Tnl po 12 urah: 39[10-86] vs. 45[12-84] pg/1, p=1,000; raven Tnl po 24 urah: 21 [16-98] vs. 23[4-84] |_ig/l, p=0,635). Vrednosti LVEF so med EPO skupino in kontrolno skupino primerljive in nismo ugotovili statistično značilnih razlik: srednja vrednost [IQR]; 47 [40-59] % vs 50 [25- 52] %; p= 0.524. Zaključek: Enkraten visok odmerek EPO apliciran med oživljanjem ne zmanjša velikost miokardnega infarkta in ne izboljša LVEF pri bolnikih s srčnim zastojem izven bolnišnice zaradi AMI.
Descriptors		HEART ARREST ERYTHROPOIETIN EMERGENCY MEDICINE