Ischemic Cardiomyopathy Clinical Trial
Official title:
Pilot Study to Assess the Effect of Low Dose Epoetin Beta Administered for Six Month in Patients With Ischemic Heart Failure Subjected to Percutaneous Coronary Intervention (PCI)
The study is testing the hypothesis, that the application of low dose erythropoetin beta (35 I.E./kg BW/week) for 6 months following successful coronary revascularization by PCI improves left ventricular remodeling as assessed by cardiac MRI.
Several effects known to be exerted by erythropoetin (EPO) directly in the heart independent
of hemoglobin levels could be of value immediately after revascularization procedures in
ischemic cardiac remodeling: the generation of new capillaries is enhanced by the
mobilization of endothelial progenitor cells from the bone marrow. EPO is neuron- and
cardio-protective after ischemia/reperfusion. Administration of EPO enhances neuronal
progenitors to differentiate into functional neurons; this observation may also be valid for
the cardiac compartment. The concept of organ-specific effects of EPO independent of
hemoglobin levels is supported by the analysis of EPO analogues lacking hematopoietic
activity. In humans, currently this concept can only be tested by the use of EPO-doses that
do not affect hemoglobin levels. The concept is valid as clinical trials have been performed
showing that doses as low as 5000 I.U. EPO once weekly increase the levels of endothelial
progenitor cells in blood. On the other hand, recent clinical trials have also shown neutral
or even deleterious effects of high dose EPO treatment raising hemoglobin levels to above
12mg/dl in pre-dialysis patients concerning cardiovascular endpoints. Therefore, the
chronic, hemoglobin-neutral administration of low doses of EPO might be a successful
approach concerning ischemic cardiomyopathy.
Study outline:
This investigator initiated, double-blind, placebo-controlled study is testing the
hypothesis, that low doses of erythropoietin beta (35 I.U./kg body weight) started within 14
days after a successful percutaneous coronary intervention enhance left ventricular
remodeling as determined by comparison of two cardiac MRI´s over a course of 6 months.
Secondary endpoints include changes in diastolic dysfunction as measured by
echocardiography, VO2 measured by spiroergometry and serum brain natriuretic peptide levels.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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