Erythropoietin therapy after out-of-hospital cardiac arrest:A systematic review and meta-analysis  

作　　者：Rahul Chaudhary Jalaj Garg Parasuram Krishnamoorthy Kevin Bliden Neeraj Shah Nayan Agarwal Rahul Gupta Abhishek Sharma Karl B Kern Nainesh C Patel Paul Gurbel 

机构地区：[1]Department of Medicine,Sinai Hospital of Baltimore,Baltimore,MD 21215,United States [2]Division of Cardiology,Lehigh Valley Health Network,Allentown,PA 18103,United States [3]Department of Medicine,Division of Cardiology,Einstein Healthcare Network,Philadelphia,PA 19141,United States [4]Inova Heart and Vascular Institute,Inova Medical Center,Fairfax,VA 22042,United States [5]Division of Cardiovascular Medicine,University of Florida,Gainesville,FL 32611,United States [6]Queens Cardiac Care,Queens,NY 11428,United States [7]Division of Cardiovascular Medicine,State University of New York,Brooklyn,NY 12246,United States [8]Division of Cardiology,University of Arizona College of Medicine,Tucson,AZ 85721,United States

出　　处：《World Journal of Cardiology》2017年第12期830-837,共8页世界心脏病学杂志（英文版）（电子版）

摘　　要：AIM To assess safety and efficacy of early erythropoietin(Epo) administration in patients with out-of-hospital cardiac arrest(OHCA).METHODS A systematic literature search was performed using PubM ed,MEDLINE,EMBASE,EBSCO,CINAHL,Web of Science and Cochrane databases,of all studies published from the inception through October 10,2016.Inclusion criteria included:(1) Adult humans with OHCA and successful sustained return of spontaneous circulation;and(2) studies including mortality/brain death,acute thrombotic events as their end points.Primary efficacyoutcome was "brain death or Cerebral Performance Category(CPC) score of 5".Secondary outcomes were "CPC score 1,and 2-4","overall thrombotic events" and "acute coronary stent thrombosis".RESULTS We analyzed a total of 606 participants(n = 276 received Epo and n = 330 with standard of care alone) who experienced OHCA enrolled in 3 clinical trials.No significant difference was observed between the Epo and no Epo group in brain death or CPC score 5(OR = 0.77;95%CI:0.42-1.39),CPC score 1(OR = 1.16,95%CI:0.82-1.64),and CPC score 2-4(OR = 0.77,95%CI:0.44-1.36).Epo group was associated with increased thrombotic complications(OR = 2.41,95%CI:1.26-4.62) and acute coronary stent thrombosis(OR = 8.16,95%CI:1.39-47.99).No publication bias was observed.CONCLUSION Our study demonstrates no improvement in neurological outcomes and increased incidence of thrombotic events and acute coronary stent thrombosis in OHCA patients who were treated with Epo in addition to standard therapy.AIM To assess safety and efficacy of early erythropoietin(Epo) administration in patients with out-of-hospital cardiac arrest(OHCA).METHODS A systematic literature search was performed using PubM ed,MEDLINE,EMBASE,EBSCO,CINAHL,Web of Science and Cochrane databases,of all studies published from the inception through October 10,2016.Inclusion criteria included:(1) Adult humans with OHCA and successful sustained return of spontaneous circulation;and(2) studies including mortality/brain death,acute thrombotic events as their end points.Primary efficacyoutcome was "brain death or Cerebral Performance Category(CPC) score of 5".Secondary outcomes were "CPC score 1,and 2-4","overall thrombotic events" and "acute coronary stent thrombosis".RESULTS We analyzed a total of 606 participants(n = 276 received Epo and n = 330 with standard of care alone) who experienced OHCA enrolled in 3 clinical trials.No significant difference was observed between the Epo and no Epo group in brain death or CPC score 5(OR = 0.77;95%CI:0.42-1.39),CPC score 1(OR = 1.16,95%CI:0.82-1.64),and CPC score 2-4(OR = 0.77,95%CI:0.44-1.36).Epo group was associated with increased thrombotic complications(OR = 2.41,95%CI:1.26-4.62) and acute coronary stent thrombosis(OR = 8.16,95%CI:1.39-47.99).No publication bias was observed.CONCLUSION Our study demonstrates no improvement in neurological outcomes and increased incidence of thrombotic events and acute coronary stent thrombosis in OHCA patients who were treated with Epo in addition to standard therapy.

关 键 词：ERYTHROPOIETIN THROMBOSIS CARDIAC ARREST CARDIOPULMONARY RESUSCITATION 

分 类 号：R541.78[医药卫生—心血管疾病]