The Japanese Journal of Clinical Dialysis Vol.24 No.1(5-1)

Theme Evolution in Management of Renal Anemia
Title Protective effects of erythropoietin against myocardial injury
Publish Date 2008/01
Author Yutaka Kagaya Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
Author Yasuhide Asaumi Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
Author Hiroko Tada Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
Author Hiroaki Shimokawa Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
[ Summary ] Recombinant human erythropoietin (EPO) has been shown to reduce infarct size in various animal models with myocardial ischemia, both with and without reperfusion. The mechanisms include suppression of apoptotic cardiomyocyte death. We recently reported that plasma EPO levels in patients with acute myocardial infarction who underwent successful percutaneous coronary intervention is an independent predictor of the infarct size. We also demonstrated that endogenous EPO-EPO receptor system plays an important protective role in preventing myocardial ischemia / reperfusion injury and pressure-overload induced heart failure using mice expressing EPO receptors exclusively in hematopoietic lineage cells. Although rHuEPO is a potential therapeutic agent for myocardial ischemia / reperfusion injury and pressure-overload induced heart failure, we should be very careful not to increase the hemoglobin levels too much. This is because two recent large-scale clinical trials demonstrated that overly high hemoglobin levels induced by the administration of rHuEPO are associated with increased risk of cardiovascular events.
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