Title |
Erythropoietin improves long-term neurological outcome in acute ischemic stroke patients: a randomized, prospective, placebo-controlled clinical trial
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Published in |
Critical Care, December 2015
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DOI | 10.1186/s13054-015-0761-8 |
Pubmed ID | |
Authors |
Tzu-Hsien Tsai, Cheng-Hsien Lu, Christopher Glenn Wallace, Wen-Neng Chang, Shu-Feng Chen, Chi-Ren Huang, Nai-Wen Tsai, Min-Yu Lan, Pei-Hsun Sung, Chu-Feng Liu, Hon-Kan Yip |
Abstract |
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 IU/dose, subcutaneously administered at 48 hours and 72 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. 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. The results showed that long-term recurrent stroke and mortality did not differ between group 1 (placebo-control; n = 71) and group 2 (EPO-treated; n = 71). Long-term Barthel index of <35 (defining a severe neurological deficit) was lower in group 2 than group 1 (P = 0.007). Multiple-stepwise logistic-regression analysis showed that EPO therapy was significantly and independently predictive of freedom from a Barthel index of <35 (P = 0.029). Long-term major adverse neurological event (MANE; defined as: death, recurrent stroke, or long-term Barthel index < 35) was lower in group 2 than group 1 (P = 0.04). Log-Rank test showed that MANE-free rate was higher in group 2 than group 1 (P = 0.031). 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 <0.04). EPO therapy significantly improved long-term neurological outcomes in patients after IS. ISRCTN71371114 . Registered 10 October 2008. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Puerto Rico | 2 | 33% |
Philippines | 1 | 17% |
France | 1 | 17% |
Mexico | 1 | 17% |
Unknown | 1 | 17% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 3 | 50% |
Practitioners (doctors, other healthcare professionals) | 3 | 50% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 1 | 2% |
Brazil | 1 | 2% |
Unknown | 60 | 97% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 13 | 21% |
Student > Master | 6 | 10% |
Student > Bachelor | 6 | 10% |
Student > Doctoral Student | 4 | 6% |
Other | 4 | 6% |
Other | 11 | 18% |
Unknown | 18 | 29% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 28 | 45% |
Neuroscience | 4 | 6% |
Pharmacology, Toxicology and Pharmaceutical Science | 2 | 3% |
Nursing and Health Professions | 2 | 3% |
Computer Science | 1 | 2% |
Other | 3 | 5% |
Unknown | 22 | 35% |