Journal
EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
Volume 8, Issue 5, Pages 503-510Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ehjcvp/pvab075
Keywords
Anakinra; Interleukin-1; STEMI; Heart failure; Inflammation
Funding
- American Heart Association Scientist Development grant [10SDG 3030051]
- Presidential Research Incentive Program of the Virginia Commonwealth University
- Institutional National Institute of Health K12 award [KL2RR031989]
- National Institutes of Health [1R34HL121402-01]
- Sapienza Universita di Roma, Italy
Ask authors/readers for more resources
This study suggests that treatment with Anakinra for 14 days can lower the incidence of new-onset HF or hospitalization for HF in patients with STEMI.
Aims ST-segment elevation myocardial infarction (STEMI) is associated with an intense acute inflammatory response and an increased risk of death and heart failure (HF). In this study, we sought to evaluate the effect of anakinra, a recombinant interleukin-1 receptor antagonist, on the incidence of HF. Methods and results We performed a pooled analysis of three early phase randomized clinical trials. The endpoints included the composite of all-cause death and new-onset HF, and the composite of all-cause death and hospitalization for HF at 1-year follow-up. Safety events, including injection site reaction and serious infections, were also recorded. We analysed 139 patients with STEMI from three separate trials: VCUART (N = 10), VCUART2 (N = 30), and VCUART3 (N = 99). Of these, 84 (60%) patients were randomized to anakinra and 55 (40%) to placebo. Treatment with anakinra significantly reduced the incidence of all-cause death or new-onset HF (7 [8.2%] vs. 16 [29.1%], log-rank P = 0.002) and of all-cause death or HF hospitalization (0 [0] vs. 5 [9.1%], log-rank P = 0.007). Patients treated with anakinra had significantly higher injection site reactions (19 [22.6%] vs. 3 [5.5%], P = 0.016) without a significant difference in the incidence of serious infections (11 [13.1%] vs. 7 [12.7%], P = 0.435). Treatment with anakinra significantly reduced the area under the curve for high-sensitivity C-reactive protein between baseline and 14 days (75.48 [41.7-147.47] vs. 222.82 [117.22-399.28] mg day/L, P < 0.001). Conclusion IL-1 blockade with anakinra for 14 days in patients with STEMI reduces the incidence of new-onset HF or hospitalization for HF at 1 year following STEMI.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available