Details

Autor(en) / Beteiligte

• Abbate, Antonio
• Trankle, Cory R
• Buckley, Leo F
• Lipinski, Michael J
• Appleton, Darryn
• Kadariya, Dinesh
• Canada, Justin M
• Carbone, Salvatore
• Roberts, Charlotte S
• Abouzaki, Nayef
• Melchior, Ryan
• Christopher, Sanah
• Turlington, Jeremy
• Mueller, George
• Garnett, James
• Thomas, Christopher
• Markley, Roshanak
• Wohlford, George F
• Puckett, Laura
• Medina de Chazal, Horacio
• Chiabrando, Juan G
• Bressi, Edoardo
• Del Buono, Marco Giuseppe
• Schatz, Aaron
• Vo, Chau
• Dixon, Dave L
• Biondi-Zoccai, Giuseppe G
• Kontos, Michael C
• Van Tassell, Benjamin W

Titel

Interleukin-1 Blockade Inhibits the Acute Inflammatory Response in Patients With ST-Segment-Elevation Myocardial Infarction

Ist Teil von

• Journal of the American Heart Association, 2020-03, Vol.9 (5), p.e014941-e014941

Ort / Verlag

England: John Wiley and Sons Inc

Erscheinungsjahr

2020

Link zum Volltext

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Background ST-segment-elevation myocardial infarction is associated with an intense acute inflammatory response and risk of heart failure. We tested whether interleukin-1 blockade with anakinra significantly reduced the area under the curve for hsCRP (high sensitivity C-reactive protein) levels during the first 14 days in patients with ST-segment-elevation myocardial infarction (VCUART3 [Virginia Commonwealth University Anakinra Remodeling Trial 3]). Methods and Results We conducted a randomized, placebo-controlled, double-blind, clinical trial in 99 patients with ST-segment-elevation myocardial infarction in which patients were assigned to 2 weeks treatment with anakinra once daily (N=33), anakinra twice daily (N=31), or placebo (N=35). hsCRP area under the curve was significantly lower in patients receiving anakinra versus placebo (median, 67 [interquartile range, 39-120] versus 214 [interquartile range, 131-394] mg·day/L; <0.001), without significant differences between the anakinra arms. No significant differences were found between anakinra and placebo groups in the interval changes in left ventricular end-systolic volume (median, 1.4 [interquartile range, -9.8 to 9.8] versus -3.9 [interquartile range, -15.4 to 1.4] mL; =0.21) or left ventricular ejection fraction (median, 3.9% [interquartile range, -1.6% to 10.2%] versus 2.7% [interquartile range, -1.8% to 9.3%]; =0.61) at 12 months. The incidence of death or new-onset heart failure or of death and hospitalization for heart failure was significantly lower with anakinra versus placebo (9.4% versus 25.7% [ =0.046] and 0% versus 11.4% [ =0.011], respectively), without difference between the anakinra arms. The incidence of serious infection was not different between anakinra and placebo groups (14% versus 14%; =0.98). Injection site reactions occurred more frequently in patients receiving anakinra (22%) versus placebo (3%; =0.016). Conclusions In patients presenting with ST-segment-elevation myocardial infarction, interleukin-1 blockade with anakinra significantly reduces the systemic inflammatory response compared with placebo. Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT01950299.