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Báo cáo y học: "Effect of erythropoietin therapy on clinical outcome in patients after acute ischemic stroke: a debatable issue"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Effect of erythropoietin therapy on clinical outcome in patients after acute ischemic stroke: a debatable issue. | Yuen et al. Critical Care 2011 15 425 http ccforum.eom content 15 3 425 CRITICAL CARE LETTER L_ Effect of erythropoietin therapy on clinical outcome in patients after acute ischemic stroke a debatable issue Chun-Man Yuen1 Cheuk-Kwan Sun2-3 Steve Leu4-5 and Hon-Kan Yip 4-5 See related research by Yip etal. http ccforum.eom content 15 1 R40 and related commentary by Minnerup etal. http ccforum.eom content 15 2 129 Our recent clinical trial has shown that erythropoietin EPO therapy significantly increased circulating endothelial progenitor cell EPC levels and was strongly associated with favorable 90-day clinical outcomes after ischemic stroke IS 1 . Contrary to the findings of our study 1 and of others 2 3 the randomized phase II III German Multicenter EPO Stroke Trial 4 which is currently the largest clinical study on EPO treatment in patients with IS not only failed to show any additional benefit but also demonstrated increased mortality after combined therapy with EPO and tissue plasminogen activator tPA 4 . Interestingly subgroup analysis of the study revealed that EPO therapy improved 90-day clinical outcome in patients without additional tPA therapy 4 . In this way the findings from the subgroup analysis of that study 4 corroborate those of our clinical trial 1 . We thank Minnerup and colleagues 5 for their comments in the previous issue of Critical Care. These authors suggested that for evaluating 90-day neurological outcome the modified Rankin Scale or the Barthel Index could be superior to the National Institutes of Health Stroke Scale NIHSS that was used in our study 5 . They also mentioned that when the components of the composite endpoint in our study protocol are considered the significantly higher number of patients with an NIHSS score of at least 8 after placebo treatment is also likely to be caused by the high rate of recurrent strokes and does not necessarily reflect improved neurological function in the EPO group 5 . However NIHSS is widely .