Preliminary Administration of EPO and Markers of Cardiac Ischemia Induced by CPB

University Hospital, Grenoble50 enrolled

Overview

The main objective is to observe the effects of erythropoietin administration on different blood markers of ischaemic cardiac lesions induced by cardiopulmonary bypass.

A new property of erythropoietin (EPO), independent of its hematopoietic role, has recently been discovered. Indeed, it has been reported that this hormone, following binding to its cardiac or cerebral receptors, is able to induce a spectacular cellular protection against ischemic injury. These cardioprotective and neuroprotective effects have been observed experimentally in rodents as well as clinically in humans. In particular, our team has demonstrated that the administration of NeoRecormon® protects the heart against ischemia in the rat by significantly improving its recovery. In view of these exciting experimental results and of the growing interest of the scientific community for cytoprotective effects of EPO, we are planning the first clinical study examining the cardiac and cerebral protective effects of EPO (NeoRecormon®) in the setting of cardiac surgery.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

QUADRUPLE

Enrollment

Conditions

Myocardial Ischemia

Interventions

epoetin betaDRUG

800UI/kg in 60ml of Nacl IV slow 1 to 3 hours before surgery

placeboDRUG

60ml of NaCl IV slow

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Coronary bypass surgery. * Surgery not urgent. * Left ventricular ejection fraction (LVEF) \> 40. * Informed consent form signed. Exclusion Criteria: * Valvular surgery. * Surgery with beating heart, with or without cardiopulmonary bypass. * Carotid bypass surgery. * Myocardial infarction less than 30 days. * Previous history of cardiac surgery. * Kidney failure (creatinine \> 200 µmol/l). * Uncontrolled hypertension. * Unstable angina. * Risk of deep venous thrombosis. * Vascular cerebral attack less than 30 days. * Malignant tumour. * Phenylketonuria. * Allergy to erythropoietin. * Previous programmed blood donation. * Pregnancy and feeding.

Locations (1)

Cardiac Surgery Department - CHU de Grenoble

Grenoble, France

Outcomes

Primary Outcomes

Area under curve and maximal plasmatic level of troponin-T, NT-pro-BNP, and creatine kinase-MB (CK-MB) after cardiopulmonary bypass

Time frame: at anaesthesia (ti), at the end of the cardiopulmonary bypass (t0), puis 6 h, 12 h, 24 h et 48h after the end of the cardiopulmonary bypass

Secondary Outcomes

Area under curve and maximal plasmatic level of protein S-100 after cardiopulmonary bypass

Time frame: at anaesthesia (ti), at the end of the cardiopulmonary bypass (t0), puis 6 h, 12 h, 24 h et 48h after the end of the cardiopulmonary bypass

Blood level of erythropoietin

Time frame: at injection and 6 hours after the end of cardiopulmonary bypass

Data from ClinicalTrials.gov

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