| Pexelizumab, an anti-C5 complement antibody, as adjunctive therapy to primary percutaneous coronary intervention in acute myocardial infarction: the COMplement inhibition in Myocardial infarction treated with Angioplasty (COMMA) trial. | |
| | |
MedLine Citation:
|
PMID: 12925454 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Complement, activated during myocardial ischemia and reperfusion, causes myocardial damage through multiple processes. The COMplement inhibition in Myocardial infarction treated with Angioplasty (COMMA) trial was performed to determine the effect of pexelizumab, a C5 complement inhibitor, on infarct size in patients with ST-segment-elevation myocardial infarction (MI) undergoing primary percutaneous coronary intervention. METHODS AND RESULTS: In COMMA, 960 patients with MI (20% isolated inferior MI) were randomized to placebo, pexelizumab 2.0-mg/kg bolus, or pexelizumab 2.0-mg/kg bolus and 0.05-mg/kg per h infusion for 20 hours. Infarct size by creatine kinase-MB area under the curve, the primary outcome, did not differ significantly between groups (placebo median, 4393; bolus pexelizumab, 4526; bolus plus infusion pexelizumab, 4713 [ng/mL] x h; P=0.89 for bolus versus placebo; P=0.76 for bolus plus infusion versus placebo), nor did the composite of 90-day death, new or worsening heart failure, shock, or stroke (placebo, 11.1%; bolus, 10.7%; bolus plus infusion, 8.5%). The ninety-day mortality rate was significantly lower with pexelizumab bolus plus infusion (1.8% versus 5.9% with placebo; nominal P=0.014); the bolus-only group had an intermediate mortality rate (4.2%). CONCLUSIONS: In patients with ST-elevation MI undergoing percutaneous coronary intervention, pexelizumab had no measurable effect on infarct size. However, the significant reduction in mortality suggests that pexelizumab may benefit patients through alternative novel mechanisms and provides impetus for additional investigation. |
| | |
Authors:
|
Christopher B Granger; Kenneth W Mahaffey; W Douglas Weaver; Pierre Theroux; Judith S Hochman; Thomas G Filloon; Scott Rollins; Thomas G Todaro; Jose C Nicolau; Witold Ruzyllo; Paul W Armstrong; |
Related Documents
:
|
19734364 - Calpain inhibition preserves myocardial structure and function following myocardial inf... 19556694 - Autonomic and cardiovascular effects of acute high altitude exposure after myocardial i... 19345314 - Spontaneous myocardial infarction and nitric oxide synthase. 1774824 - Stenotic lesions and the bifurcation angle of coronary arteries in the young. 19668244 - Sudden unexpected death in epilepsy: risk factors and potential pathomechanisms. 19710214 - Ejection fraction/velocity ratio identifies prosthesis-patient mismatches in patients w... |
Publication Detail:
|
Type: Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2003-08-18 |
Journal Detail:
|
Title: Circulation Volume: 108 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2003 Sep |
Date Detail:
|
Created Date: 2003-09-09 Completed Date: 2003-10-03 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
|
Languages: eng Pagination: 1184-90 Citation Subset: AIM; IM |
Affiliation:
|
Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715, USA. grang001@mc.duke.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Angioplasty, Transluminal, Percutaneous Coronary* Antibodies, Monoclonal / adverse effects, therapeutic use* Area Under Curve Chemotherapy, Adjuvant Complement C5 / antagonists & inhibitors* Creatine Kinase / analysis Creatine Kinase, MB Form Female Follow-Up Studies Humans Isoenzymes / analysis Male Middle Aged Myocardial Infarction / mortality, therapy* Survival Analysis Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Antibodies, Monoclonal; 0/Complement C5; 0/Isoenzymes; 0/h5G1.1-scFv; EC 2.7.3.2/Creatine Kinase; EC 2.7.3.2/Creatine Kinase, MB Form |
| Comments/Corrections | |
Comment In:
|
Circulation. 2003 Sep 9;108(10):e9018-26
[PMID:
12963691
]
Circulation. 2004 Apr 27;109(16):e195-6; author reply e195-6 [PMID: 15117866 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Lack of adverse clopidogrel-atorvastatin clinical interaction from secondary analysis of a randomize...
Next Document: Effect of pexelizumab, an anti-C5 complement antibody, as adjunctive therapy to fibrinolysis in acut...