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Erythropoietin in Patients With Acute Myocardial Infarction: No Proof of Effectiveness or Proof of No Effectiveness?

To the Editor: In patients who have experienced a myocardial infarction (MI), the treatment with erythropoietin (EPO) does not seem to be beneficial.1 There is not, however, complete agreement on this point. On the one hand, after examining the data of 10 randomized placebo-controlled studies, a recent meta-analysis1 found no significant improvement in left ventricular ejection fraction (LVEF) (absolute improvement of 0.33% with the 95% confidence interval from −1.24% to 1.90%, P = 0.68). Likewise, no improvement was found in other relevant end points. On the other hand, further studies on this treatment are being undertaken,2 and a query of clinicaltrials.gov (run on June 5, 2013) indicates that 5 trials registered on this Web site are presently under way. The statistical question addressed by the aforesaid metaanalysis1 was whether or not the 10 randomized vs placebobased trials evaluating EPO showed superiority on the