BACKGROUND: In experimental models of acute myocardial infarction (AMI), 
erythropoietin (EPO) reduces infarct size and improves left ventricular (LV) 
function. However, in the clinical setting, the effect of EPO in AMI was 
unclear. We conducted a systematic review and meta-analysis of randomized 
controlled trials (RCTs) of EPO to explore the safety and therapeutic effects of 
EPO in patients with AMI.
METHODS: We identified reports of RCTs comparing EPO to placebo for AMI in adult 
humans in PubMed, Cochrane Central Register of Controlled Trials, and EMBASE. 
Outcomes included all-cause mortality, major cardiovascular events, cardiac 
function by LV ejection fraction and infarct size.
RESULTS: We included 13 articles of RCTs with data for 1,564 patients. 
Erythropoietin therapy did not improve LV ejection fraction (weighted mean 
difference [WMD] 0.33, 95% CI -1.90 to 1.24, P = .68) and had no effect on 
infarct size, as measured by cardiac magnetic resonance imaging (WMD -0.12, 
-2.16 to 1.91, P = .90) or serum peak value of creatine kinase-MB (WMD -2.01, 
-25.70 to 21.68, P = .87). Erythropoietin treatment did not decrease the risk of 
total adverse cardiac events (relative risk [RR] 1.02, 0.65-1.61, P = .92). 
Erythropoietin treatment also failed to decrease the risk of heart failure (RR, 
0.69, 0.27-1.72, P = .42) and all-cause mortality (RR 0.55, 0.22-1.33, P = .18). 
Moreover, EPO had no effect on the risk of stent thrombosis (RR, 0.69, 
0.29-1.64, P = .40).
CONCLUSION: Erythropoietin in patients with AMI seems to have no clinical 
benefit for heart function or reducing infarct size, cardiovascular events, and 
all-cause mortality. Erythropoietin may not be a choice for patients with AMI.