The ROXAMI trial was an open-label, randomized clinical trial conducted at a single tertiary medical center between April 2021 and March 2024, with follow-up through 1 year. A total of 158 patients were randomized to receive oral roxadustat (100 mg three times weekly for 2 weeks, initiated within 2 hours after primary percutaneous coronary intervention [PCI]) or standard care alone.

Among 148 patients with evaluable imaging, mean infarct size at 30 days was 23.3% of the left ventricle with roxadustat versus 22.0% with standard care (mean difference, 1.3 percentage points; 95% confidence interval [CI], −2.7 to 5.3; P = .51).Major adverse cardiovascular events occurred in 3.8% versus 8.9% of patients, respectively (hazard ratio, 0.42; 95% CI, 0.11–1.63; P = .21), without a statistically significant difference. At 12 months, left ventricular ejection fraction increased by 3.4% with…