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Prognostic significance of blood markers of inflammation in patients with ST-segment elevation myocardial infarction undergoing primary angioplasty and effects of pexelizumab, a C5 inhibitor: a substudy of the COMMA trial.
- Source :
-
European heart journal [Eur Heart J] 2005 Oct; Vol. 26 (19), pp. 1964-70. Date of Electronic Publication: 2005 May 04. - Publication Year :
- 2005
-
Abstract
- Aims: Pexelizumab, a monoclonal antibody inhibiting C5, reduced 90 day mortality and shock in the COMplement inhibition in Myocardial infarction treated with Angioplasty (COMMA) trial without apparent reductions in infarct size. Inflammation is a critical component of ST-elevation myocardial infarction (STEMI); this substudy examines prognostic values of selected markers and treatment effects.<br />Methods and Results: C-reactive protein, interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-alpha) serum levels were assessed in 337 patients enrolled in either the placebo or the pexelizumab 24 h infusion group. Higher C-reactive protein and IL-6 levels at baseline, 24 h, and 72 h were strongly associated with increased subsequent death (P<0.002 at baseline and 24 h, P<0.02 at 72 h); and all baseline marker levels with death or cardiogenic shock (P<0.03) within 90 days. C-reactive protein and IL-6 levels were similar at baseline, but significantly lower 24 h later with pexelizumab, when compared with placebo (17.1 vs. 25.5 mg/L, P=0.03 and 51.0 vs. 63.8 pg/mL, P=0.04, respectively). At 72 h, corresponding levels were similar, whereas TNF-alpha was slightly higher (P=0.04) in the treated group.<br />Conclusion: Inflammation markers and their serial changes predict death and shock in patients with STEMI undergoing primary angioplasty. Pexelizumab reduced C-reactive protein and IL-6, suggesting treatment benefits mediated through anti-inflammatory effects.
- Subjects :
- Aged
Antibodies, Monoclonal, Humanized
Biomarkers blood
C-Reactive Protein metabolism
Enzyme-Linked Immunosorbent Assay
Female
Humans
Interleukin-6 blood
Male
Middle Aged
Myocardial Infarction blood
Myocardial Infarction mortality
Single-Chain Antibodies
Treatment Outcome
Tumor Necrosis Factor-alpha analysis
Antibodies, Monoclonal therapeutic use
Complement C5 antagonists & inhibitors
Myocardial Infarction drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0195-668X
- Volume :
- 26
- Issue :
- 19
- Database :
- MEDLINE
- Journal :
- European heart journal
- Publication Type :
- Academic Journal
- Accession number :
- 15872036
- Full Text :
- https://doi.org/10.1093/eurheartj/ehi292