Document Detail


Continuous 48-h C1-inhibitor treatment, following reperfusion therapy, in patients with acute myocardial infarction.
MedLine Citation:
PMID:  12398824     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Complement inhibition by C1-inhibitor has been shown to reduce myocardial ischaemia-reperfusion injury in animal models. We therefore studied the effects of intravenous C1-inhibitor, following reperfusion therapy, in patients with acute myocardial infarction. METHODS AND RESULTS: C1-inhibitor therapy was started not earlier than 6h after acute myocardial infarction, in order to prevent interference with thrombolytic therapy. A loading dose of C1-inhibitor was followed by a continuous infusion for 48 h, using three escalating dosage schemes. Efficacy of complement inhibition was estimated from C4 activation fragments. Plasma concentrations of myocardial proteins were compared to values measured in matched control patients. In 22 patients, C1-inhibitor was well tolerated and drug-related adverse events were not observed. Target plasma levels of C1-inhibitor were reached, with values of 48.2 ml.kg(-1) for distribution space and 35.5h for the half-life time of C1-inhibitor. A dose-dependent reduction of C4 fragments was found P=0.005). In 13 patients who received early thrombolytic therapy, release of troponin T and creatine kinase-MB(mass) was reduced by 36% and 57%P =0.001), compared to 18 controls. CONCLUSION: Continuous 48-h treatment with C1-inhibitor provides safe and effective inhibition of complement activation after reperfused acute myocardial infarction and may reduce myocardial injury.
Authors:
C de Zwaan; A H Kleine; J H C Diris; J F C Glatz; H J J Wellens; P F W Strengers; M Tissing; C E Hack; M P van Dieijen-Visser; W T Hermens
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European heart journal     Volume:  23     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-10-25     Completed Date:  2003-02-12     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1670-7     Citation Subset:  IM    
Affiliation:
Department of Cardiology, University Hospital Maastricht, Maastricht, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary / methods
Complement Activation
Complement C1 Inactivator Proteins / administration & dosage*
Complement C4
Dose-Response Relationship, Drug
Female
Fibrinolytic Agents / therapeutic use
Humans
Male
Middle Aged
Myocardial Infarction / drug therapy*,  surgery
Myocardial Reperfusion / methods*
Postoperative Care / methods
Prospective Studies
Time Factors
Chemical
Reg. No./Substance:
0/Complement C1 Inactivator Proteins; 0/Complement C4; 0/Fibrinolytic Agents
Comments/Corrections
Comment In:
Eur Heart J. 2002 Nov;23(21):1640-2   [PMID:  12398819 ]

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