Erythropoietin improves long-term neurological outcome in acute ischemic stroke patients: a randomized, prospective, placebo-controlled clinical trial

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• 作者：Tzu-Hsien Tsai (1)
  Cheng-Hsien Lu (2)
  Christopher Glenn Wallace (3)
  Wen-Neng Chang (2)
  Shu-Feng Chen (2)
  Chi-Ren Huang (2)
  Nai-Wen Tsai (2)
  Min-Yu Lan (2)
  Pei-Hsun Sung (1)
  Chu-Feng Liu (4)
  Hon-Kan Yip (1) (5) (6) (7)
  
  1. Division of Cardiology ; Department of Internal Medicine ; Kaohsiung Chang Gung Memorial Hospital ; Kaohsiung 123 ; Ta Pei Road ; Niao Sung Hsiang ; Kaohsiung ; Hsien ; 83301 ; Taiwan
  2. Department of Neurology ; Kaohsiung Chang Gung Memorial Hospital ; Kaohsiung 123 ; Ta Pei Road ; Niao Sung Hsiang ; Kaohsiung ; Hsien ; 83301 ; Taiwan
  3. Department of Plastic Surgery ; University Hospital of South Manchester ; Southmoor Road ; Manchester ; M23 9LT ; UK
  4. Department of Emergency Medicine ; Kaohsiung Chang Gung Memorial Hospital ; Kaohsiung 123 ; Ta Pei Road ; Niao Sung Hsiang ; Kaohsiung ; Hsien ; 83301 ; Taiwan
  5. Center for Translational Research in Biomedical Sciences ; Kaohsiung Chang Gung Memorial Hospital ; Kaohsiung 123 ; Ta Pei Road ; Niao Sung Hsiang ; Kaohsiung ; Hsien ; 83301 ; Taiwan
  6. Institute of Shock Wave Medicine and Tissue Engineering ; Kaohsiung Chang Gung Memorial Hospital ; 123 ; Ta Pei Road ; Niao Sung Hsiang ; Kaohsiung ; Hsien ; 83301 ; Taiwan
  7. Chang Gung University College of Medicine ; 123 ; Ta Pei Road ; Niao Sung Hsiang ; Kaohsiung ; Hsien ; 83301 ; Taiwan
  
• 刊名：Critical Care
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：19
• 期：1
• 全文大小：486 KB
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• 刊物主题：Intensive / Critical Care Medicine; Emergency Medicine;
• 出版者：BioMed Central
• ISSN：1364-8535

文摘

Introduction Mortality and disability following ischemic stroke (IS) remains unacceptably high with respect to the conventional therapies. This study tested the effect of erythropoietin (EPO) on long-term neurological outcome in patients after acute IS. This study aimed to evaluate the safety and efficacy of two consecutive doses of EPO (5,000聽IU/dose, subcutaneously administered at 48聽hours and 72聽hours after acute IS) on improving the 90-day combined endpoint of recurrent stroke or death that has been previously reported. A secondary objective was to evaluate the long-term (that is, five years) outcome of patients who received EPO. Methods This was a prospective, randomized, placebo-controlled trial that was conducted between October 2008 and March 2010 in a tertiary referral center. IS stroke patients who were eligible for EPO therapy were enrolled into the study. Results The results showed that long-term recurrent stroke and mortality did not differ between group 1 (placebo-control; n鈥?鈥?1) and group 2 (EPO-treated; n鈥?鈥?1). Long-term Barthel index of P鈥?鈥?.007). Multiple-stepwise logistic-regression analysis showed that EPO therapy was significantly and independently predictive of freedom from a Barthel index of P鈥?鈥?.029). Long-term major adverse neurological event (MANE; defined as: death, recurrent stroke, or long-term Barthel index鈥?鈥?5) was lower in group 2 than group 1 (P鈥?鈥?.04). Log-Rank test showed that MANE-free rate was higher in group 2 than group 1 (P鈥?鈥?.031). Multiple-stepwise Cox-regression analysis showed that EPO therapy and higher Barthel Index at day 90 were independently predictive of freedom from long-term MANE (all P Conclusion EPO therapy significantly improved long-term neurological outcomes in patients after IS. Trial registration ISRCTN71371114. Registered 10 October 2008.