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

Authors

Rahul Chaudhary MD
Jalaj Garg MD, Lehigh Valley Health NetworkFollow
Parasuram Krishnamoorthy MD
Kevin P. Bliden
Neeraj Shah MD, Lehigh Valley Health NetworkFollow
Nayan Agarwal MD
Rahul Gupta MD
Abhishek Sharma MD
Karl B. Kern MD
Nainesh C. Patel MD, Lehigh Valley Health NetworkFollow
Paul A. Gurbel MD

Publication/Presentation Date

12-26-2017

Abstract

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 PubMed, 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 efficacy outcome 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.

Volume

9

Issue

12

First Page

830

Last Page

837

ISSN

1949-8462

Published In/Presented At

Chaudhary, R., Garg, J., Krishnamoorthy, P., Bliden, K., Shah, N., Agarwal, N., & ... Gurbel, P. (2017). Erythropoietin therapy after out-of-hospital cardiac arrest: A systematic review and meta-analysis. World Journal Of Cardiology, 9(12), 830-837. doi:10.4330/wjc.v9.i12.830

Disciplines

Cardiology | Medical Sciences | Medicine and Health Sciences

PubMedID

29317989

Department(s)

Department of Medicine, Cardiology Division, Department of Medicine Fellows and Residents

Document Type

Article