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In a randomized double-blinded clinical trial of patients with ST segment elevation myocardial infarction (STEMI), goflikicept, an Interleukin-1 (IL-1) blocker, significantly reduced systemic inflammation, measured as the area-under-the-curve (AUC) for high-sensitivity C reactive protein (hsCRP) at 14 days. We report secondary analyses of biomarkers at 28 days, and cardiac function and clinical endpoints at 1 year. Patients received a single administration of goflikicept 80 mg (n=34), goflikicept 160 mg (n=34), or placebo (n=34). Both doses of goflikicept significantly reduced the AUC for hsCRP at 28 days compared with placebo, without statistically significant differences between the doses. There we no statistically significant differences between groups in the AUC for natriuretic peptides at 28 days. There were no significant differences between placebo, goflikicept 80 mg and 160 mg groups in deaths (2.9%, 2.9% and 0%), hospitalization for cardiovascular reasons (9.1%, 5.9%, and 0%), new-onset or progression of heart failure (9.1%, 5.9%, and 5.9%), and new or increased use of loop diuretics (24.2%, 14.7%, and 17.6%), nor in the number of patients with treatment emergent adverse events, with no treatment-related serious adverse events in any group. In conclusion, in patients with STEMI, IL-1 blockade with goflikicept 80 mg or 160 mg was well tolerated and associated with significant reduction of systemic inflammation. Further adequately powered studies are warranted to determine whether the reduction in systemic inflammation with goflikicept translates into a clinical benefit in patients with STEMI., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Presently, atherosclerosis is considered to be not only a disease caused by dysmetabolism and lipid transport disturbances, but also a lingering chronic vascular wall inflammation. This causes researchers to carry out active studies of inflammation mediators, among which acute phase markers, such as C-reactive protein (CRP), serum fibrinogen, and leucocytes, form an individual group. The data from numerous epidemiologic studies evidence that some of the inflammation markers present additional and independent cardiovascular risk factors. However, considering possibilities provided by them, and possibilities of their routine use to detect lingering chronic vascular inflammation, CRP is the optimal marker. Presently, new techniques that allow detection of the so called high sensitive CRP (hsCRP) have been developed and are in use. Nowadays, detection of hsCRP, due to its high information value, plays a leading role in evaluation of the risk of future thrombovascular events.

There is now doubt today that inflammation plays one of the key roles in the development of atherosclerosis. Numerous data demonstrate a connection between acute cardiovascular complications and laboratory signs of inflammation. There is a connection between signs of inflammation and an unfavorable prognosis in cardiovascular patients. Proinflammatory cytokines are divided into several groups: interleukins, interferons, tumor necrosis factors, colony stimulating factors, and hemopoietic cytokines. All these groups of cytokines are involved in the immune inflammation process in atherosclerosis.