Design and rationale of the Reduction of Infarct Expansion and Ventricular Remodeling with Erythropoietin after Large Myocardial Infarction (REVEAL) trial

Chiara Melloni, Sunil V. Rao, Thomas J. Povsic, Laura Melton, Raymond J. Kim, Rakhi Kilaru, Manesh R. Patel, Mark Talan, Luigi Ferrucci, Dan L. Longo, Edward G. Lakatta, Samer S. Najjar, Robert A. Harrington

Research output: Contribution to journalArticle

Abstract

Background: Acute myocardial infarction (MI) remains a leading cause of death despite advances in pharmacologic and percutaneous therapies. Animal models of ischemia/reperfusion have demonstrated that single-dose erythropoietin may reduce infarct size, decrease apoptosis, and increase neovascularization, possibly through mobilization of endothelial progenitor cells. Study Design: REVEAL is a randomized, double-blind, placebo-controlled, multicenter trial evaluating the effects of epoetin α on infarct size and left ventricular remodeling in patients with large MIs. The trial comprises a dose-escalation safety phase and a single-dose efficacy phase using the highest acceptable epoetin α dose up to 60,000 IU. Up to 250 ST-segment elevation myocardial infarction patients undergoing primary or rescue percutaneous coronary intervention will be randomized to intravenous epoetin α or placebo within 4 hours of successful reperfusion. The primary study end point is infarct size expressed as a percentage of left ventricular mass, as measured by cardiac magnetic resonance imaging 2 to 6 days post study medication administration. Secondary end points will assess changes in endothelial progenitor cell numbers and changes in indices of ventricular remodeling. Conclusion: The REVEAL trial will evaluate the safety and efficacy of the highest tolerated single dose of epoetin α in patients who have undergone successful rescue or primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction.

Original languageEnglish (US)
Pages (from-to)795-803.e1-e2
JournalAmerican heart journal
Volume160
Issue number5
DOIs
StatePublished - Nov 2010
Externally publishedYes

    Fingerprint

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Melloni, C., Rao, S. V., Povsic, T. J., Melton, L., Kim, R. J., Kilaru, R., Patel, M. R., Talan, M., Ferrucci, L., Longo, D. L., Lakatta, E. G., Najjar, S. S., & Harrington, R. A. (2010). Design and rationale of the Reduction of Infarct Expansion and Ventricular Remodeling with Erythropoietin after Large Myocardial Infarction (REVEAL) trial. American heart journal, 160(5), 795-803.e1-e2. https://doi.org/10.1016/j.ahj.2010.09.007