0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Letters |

Erythropoietin in Patients With ST-Segment Elevation Myocardial Infarction—Reply

Samer S. Najjar, MD; Sunil V. Rao, MD; Robert A. Harrington, MD
JAMA. 2011;306(7):705-706. doi:10.1001/jama.2011.1145.
Text Size: A A A
Published online

Extract

In Reply: Drs Krapf and Hulter inquire whether the increased risk of death, recurrent MI, stroke, or stent thrombosis in the active treatment group of the REVEAL trial may have been related to erythropoietin's hypertensive effect. This effect is thought to be related to arterial vasoconstriction and independent of erythropoietin's effect on hematocrit and blood viscosity.1 The REVEAL trial excluded patients with uncontrolled hypertension, defined as a systolic BP greater than 180 mm Hg or a diastolic BP greater than 110 mm Hg. Blood pressure did not differ between the 2 treatment groups at baseline, nor at the first time point that was assessed, a mean (SD) 24 (12) hours after study drug administration. In both the active and placebo treatment groups, systolic BP decreased on average from baseline to the first time point (by 11 [21] and 13 [20] mm Hg, respectively) as did diastolic blood pressure (by 8 [15] and 10 [14] mm Hg, respectively). The large standard deviations reflect the myriad factors that influence BP in patients with acute STEMI, such as presence and severity of symptoms and discomfort, as well as heterogeneity in the doses of guideline-recommended medications with antihypertensive effects (such as β-blockers and angiotensin antagonists) that are used in these patients. Therefore, it is not possible to ascertain a specific BP effect for erythropoietin in the REVEAL trial.

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Letters

August 17, 2011
Reto Krapf, MD; Henry N. Hulter, MD
JAMA. 2011;306(7):705-706. doi:10.1001/jama.2011.1143.
August 17, 2011
Yucheng Chen, MD
JAMA. 2011;306(7):705-706. doi:10.1001/jama.2011.1144.
CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();