| 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. | |
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MedLine Citation:
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PMID: 15872036 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2005-05-04 |
Journal Detail:
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Title: European heart journal Volume: 26 ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 2005 Oct |
Date Detail:
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Created Date: 2005-09-19 Completed Date: 2006-03-14 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 1964-70 Citation Subset: IM |
Affiliation:
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Montreal Heart Institute, Montreal, 5000 Belanger E, Montreal, Quebec, Canada H1T 1C8. pierre.theroux@icm-mhl.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Antibodies, Monoclonal / therapeutic use* Biological Markers / blood C-Reactive Protein / metabolism Complement C5 / antagonists & inhibitors* Enzyme-Linked Immunosorbent Assay Female Humans Interleukin-6 / blood Male Middle Aged Myocardial Infarction / blood, drug therapy*, mortality Treatment Outcome Tumor Necrosis Factor-alpha / analysis |
| Chemical | |
Reg. No./Substance:
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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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