The REVEAL study

REVEAL 研究

基本信息

  • 批准号:
    8552344
  • 负责人:
  • 金额:
    $ 4.99万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
  • 资助国家:
    美国
  • 起止时间:
  • 项目状态:
    未结题

项目摘要

Context: Acute ST-segment elevation myocardial infarction (STEMI) is a leading cause of morbidity and mortality. In experimental models of MI, erythropoietin reduces infarct size and improves left ventricular (LV) function. Objective: To evaluate the safety and efficacy of a single intravenous bolus of epoetin alfa in patients with STEMI. Design, Setting, and Patients: A prospective, randomized, double-blind, placebocontrolled trial with a dose-escalation safety phase and a single dose (60 000 U of epoetin alfa) efficacy phase; the Reduction of Infarct Expansion and Ventricular Remodeling With Erythropoietin After Large Myocardial Infarction (REVEAL) trial was conducted at 28 US sites between October 2006 and February 2010, and included 222 patients with STEMI who underwent successful percutaneous coronary intervention (PCI) as a primary or rescue reperfusion strategy. Intervention: Participants were randomly assigned to treatment with intravenous epoetin alfa or matching saline placebo administered within 4 hours of reperfusion. Main Outcome Measure: Infarct size, expressed as percentage of LV mass, assessed by cardiac magnetic resonance (CMR) imaging performed 2 to 6 days after study medication administration (first CMR) and again 122 weeks later (second CMR). Results In the efficacy cohort, the infarct size did not differ between groups on either the first CMR scan (n=136; 15.8% LV mass 95% confidence interval CI, 13.3- 18.2% LV mass for the epoetin alfa group vs 15.0% LV mass 95% CI, 12.6-17.3% LV mass for the placebo group; P=.67) or on the second CMR scan (n=124; 10.6% LV mass 95% CI, 8.4-12.8% LV mass vs 10.4% LV mass 95% CI, 8.5-12.3% LV mass, respectively; P=.89). In a prespecified analysis of patients aged 70 years or older (n=21), the mean infarct size within the first week (first CMR) was larger in the epoetin alfa group (19.9% LV mass; 95% CI, 14.0-25.7% LV mass) than in the placebo group (11.7% LV mass; 95% CI, 7.2-16.1% LV mass) (P=.03). In the safety cohort, of the 125 patients who received epoetin alfa, the composite outcome of death, MI, stroke, or stent thrombosis occurred in 5 (4.0%; 95% CI, 1.31%-9.09%) but in none of the 97 who received placebo (P=.04). Conclusions: In patients withSTEMIwhohad successful reperfusion with primary or rescue PCI, a single intravenous bolus of epoetin alfa within 4 hours of PCI did not reduce infarct size and was associated with higher rates of adverse cardiovascular events. Subgroup analyses raised concerns about an increase in infarct size among older patients. In a follow-up study, we aimed to determine the feasibility of centrally analyzing EPCs levels to assess the relationship between EPC levels, and EPO administration and infarct size. Methods: Mononuclear cells (MNCs) were locally cryopreserved for central processing from samples obtained prior to rescue or primary percutaneous coronary intervention, as well as at 24 h and 48C72 h postintervention, and analyzed for cells expressing CD133, CD34, and aldehyde dehydrogenase activity. Results: Sampling of EPCs was attempted in 163 of 222 enrolled patients. At least one analyzable sample was obtained in 125 patients, and all three time points were available in 83 patients. There were no statistically significant differences in EPC numbers over time or in the absolute EPC levels between EPO- and placebo-treated patients. There was a trend toward a greater increase in EPC levels from 24 h postintervention to 48C72 h postintervention in patients receiving 30 000 U of EPO ( = 0.11 (placebo) vs 0.092 (EPO), p=0.05). EPC numbers at baseline were inversely related to infarct size (p=0.006, r=-0.39). Conclusions: Local whole cell cryopreservation and central EPC analysis is possible. High-dose (30 000 U) EPO may mobilize EPCs at 48C72 h. Baseline EPC levels are inversely associated with infarct size, suggesting that acute EPC mobilization may be a viable strategy to minimize acute injury.
背景:急性st段抬高型心肌梗死(STEMI)是主要原因

项目成果

期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ monograph.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ sciAawards.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ conferencePapers.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ patent.updateTime }}

Edward Lakatta其他文献

Edward Lakatta的其他文献

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

{{ truncateString('Edward Lakatta', 18)}}的其他基金

A PUFA Dietary Intervention for Heart Rate
PUFA 饮食干预心率
  • 批准号:
    8335786
  • 财政年份:
  • 资助金额:
    $ 4.99万
  • 项目类别:
Decreased pacemaker activity in aged sinoatrial node
老年窦房结起搏器活动减少
  • 批准号:
    8335801
  • 财政年份:
  • 资助金额:
    $ 4.99万
  • 项目类别:
Soluble Receptor for Advanced Glycation End Products for Therapeutic Application
用于治疗应用的高级糖基化终产物的可溶性受体
  • 批准号:
    8552494
  • 财政年份:
  • 资助金额:
    $ 4.99万
  • 项目类别:
Therapeutic Potential of EPO and its Derivatives for Reducing Blood Pressure
EPO 及其衍生物降低血压的治疗潜力
  • 批准号:
    9147229
  • 财政年份:
  • 资助金额:
    $ 4.99万
  • 项目类别:
The VALIDATE study
验证研究
  • 批准号:
    8736504
  • 财政年份:
  • 资助金额:
    $ 4.99万
  • 项目类别:
Effects Of Age And Conditioning Status On Rest And Exercise Cardiac Performance
年龄和体能状态对休息和运动心脏功能的影响
  • 批准号:
    8931601
  • 财政年份:
  • 资助金额:
    $ 4.99万
  • 项目类别:
Matching ATP supply and demand in cardiac pacemaker cells
匹配心脏起搏细胞中的 ATP 供应和需求
  • 批准号:
    8931611
  • 财政年份:
  • 资助金额:
    $ 4.99万
  • 项目类别:
PDE3, PDE4 and PKC regulate local Ca2+ releases and cardiac pacemaker firing
PDE3、PDE4 和 PKC 调节局部 Ca2 释放和心脏起搏器放电
  • 批准号:
    8736511
  • 财政年份:
  • 资助金额:
    $ 4.99万
  • 项目类别:
Age-Associated Changes in Arterial Proteome and Aortic Smooth Muscle Signaling
动脉蛋白质组和主动脉平滑肌信号与年龄相关的变化
  • 批准号:
    8931487
  • 财政年份:
  • 资助金额:
    $ 4.99万
  • 项目类别:
A PUFA Dietary Intervention for Heart Rate
PUFA 饮食干预心率
  • 批准号:
    8552336
  • 财政年份:
  • 资助金额:
    $ 4.99万
  • 项目类别:

相似海外基金

Non-invasive coronary thrombus imaging to define the cause of acute myocardial infarction
无创冠状动脉血栓显像可明确急性心肌梗塞的病因
  • 批准号:
    MR/Y009770/1
  • 财政年份:
    2023
  • 资助金额:
    $ 4.99万
  • 项目类别:
    Fellowship
Impact of COVID-19 pandemic on pathophysiology of acute myocardial infarction and emergency cardiovascular care system
COVID-19大流行对急性心肌梗死病理生理学和心血管急诊系统的影响
  • 批准号:
    23K15160
  • 财政年份:
    2023
  • 资助金额:
    $ 4.99万
  • 项目类别:
    Grant-in-Aid for Early-Career Scientists
Extreme Heat and Acute Myocardial Infarction: Effect Modifications by Sex, Medical History, and Air Pollution
酷热和急性心肌梗塞:性别、病史和空气污染的影响
  • 批准号:
    10709134
  • 财政年份:
    2023
  • 资助金额:
    $ 4.99万
  • 项目类别:
Development of a multi-RNA signature in blood towards a rapid diagnostic test to robustly distinguish patients with acute myocardial infarction
开发血液中的多 RNA 特征以进行快速诊断测试,以强有力地区分急性心肌梗死患者
  • 批准号:
    10603548
  • 财政年份:
    2023
  • 资助金额:
    $ 4.99万
  • 项目类别:
Effectiveness of Strategies to Improve Outcomes after Hospitalization for Acute Myocardial Infarction in Older Adults
改善老年人急性心肌梗死住院后预后的策略的有效性
  • 批准号:
    10576349
  • 财政年份:
    2022
  • 资助金额:
    $ 4.99万
  • 项目类别:
Establishment of the emergency transport decision making program for patients with acute myocardial infarction using artificial intelligence (AI)
利用人工智能(AI)建立急性心肌梗死患者紧急转运决策方案
  • 批准号:
    22K09185
  • 财政年份:
    2022
  • 资助金额:
    $ 4.99万
  • 项目类别:
    Grant-in-Aid for Scientific Research (C)
Evaluation of effect of intracoronary supersaturated oxygen therapy on inhibition of no reflow phenomenon in acute myocardial infarction
冠状动脉内过饱和氧治疗抑制急性心肌梗死无复流现象的效果评价
  • 批准号:
    22K08135
  • 财政年份:
    2022
  • 资助金额:
    $ 4.99万
  • 项目类别:
    Grant-in-Aid for Scientific Research (C)
Developing Federated Learning Strategies for Disease Surveillance Using Cross-Jurisdiction Electronic Medical Records without Data Sharing: With Applications to Acute Myocardial Infarction, Hypertension, and Sepsis Detection
使用跨辖区电子病历(无需数据共享)开发疾病监测联合学习策略:在急性心肌梗塞、高血压和脓毒症检测中的应用
  • 批准号:
    468573
  • 财政年份:
    2022
  • 资助金额:
    $ 4.99万
  • 项目类别:
    Operating Grants
Effectiveness of Strategies to Improve Outcomes after Hospitalization for Acute Myocardial Infarction in Older Adults
改善老年人急性心肌梗死住院后预后的策略的有效性
  • 批准号:
    10339915
  • 财政年份:
    2022
  • 资助金额:
    $ 4.99万
  • 项目类别:
The Personalising Acute Myocardial Infarction Care to improve Outcomes (PAMICO Project)
个性化急性心肌梗死护理以改善结果(PAMICO 项目)
  • 批准号:
    nhmrc : 2005797
  • 财政年份:
    2021
  • 资助金额:
    $ 4.99万
  • 项目类别:
    Partnership Projects
{{ showInfoDetail.title }}

作者:{{ showInfoDetail.author }}

知道了