Document Detail

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.
MedLine Citation:
PMID:  15872036     Owner:  NLM     Status:  MEDLINE    
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. 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. 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.
Pierre Théroux; Paul W Armstrong; Kenneth W Mahaffey; Judith S Hochman; Kevin J Malloy; Scott Rollins; Jose C Nicolau; Joel Lavoie; The Minh Luong; Jeb Burchenal; Christopher B Granger
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2005-05-04
Journal Detail:
Title:  European heart journal     Volume:  26     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-09-19     Completed Date:  2006-03-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1964-70     Citation Subset:  IM    
Montreal Heart Institute, Montreal, 5000 Belanger E, Montreal, Quebec, Canada H1T 1C8.
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MeSH Terms
Antibodies, Monoclonal / therapeutic use*
Biological Markers / blood
C-Reactive Protein / metabolism
Complement C5 / antagonists & inhibitors*
Enzyme-Linked Immunosorbent Assay
Interleukin-6 / blood
Middle Aged
Myocardial Infarction / blood,  drug therapy*,  mortality
Treatment Outcome
Tumor Necrosis Factor-alpha / analysis
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Biological Markers; 0/Complement C5; 0/Interleukin-6; 0/Tumor Necrosis Factor-alpha; 0/h5G1.1-scFv; 9007-41-4/C-Reactive Protein

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