Document Detail


The effect of blockade of the CD11/CD18 integrin receptor on infarct size in patients with acute myocardial infarction treated with direct angioplasty: the results of the HALT-MI study.
MedLine Citation:
PMID:  12383565     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study was to determine whether Hu23F2G (LeukoArrest), an antibody to the CD11/CD18 integrin receptors, would reduce infarct size in patients undergoing primary angioplasty for an acute myocardial infarction. BACKGROUND: Reperfusion injury in acute myocardial infarction has been shown experimentally to be related to neutrophil accumulation. Inhibitors of the CD11/CD18 or CD18 integrin receptors have been shown to reduce infarct size in experimental models. METHODS: Patients within 6 h of onset of chest pain with ST-segment elevation were randomized to receive either 0.3 mg/kg or 1.0 mg/kg of Hu23F2G or placebo just before angioplasty of occluded arteries (Thrombolysis in Myocardial Infarction TIMI flow grade 0 or 1). The primary end point was infarct size as measured by sestamibi single-photon emission computed tomography (SPECT) scan five to nine days later. RESULTS: Four-hundred and twenty patients were enrolled and received a placebo or the study drug. The groups did not differ in baseline or angiographic characteristics or angioplasty results. Infarct size was 16%, 17.2% and 16.6%, for placebo, 0.3 mg/kg and 1.0 mg/kg, respectively, of the left ventricle (p = NS). No differences were evident in those patients with anterior myocardial infarction or those presenting within 2 h of onset of chest pain. Corrected TIMI frame count was also not different between groups. Clinical events at 30 days were very low, with a mortality of 0.8%, 1.4% and 3.3%, respectively. The drug was well tolerated, with a slight increase in minor infections in the high dose group. CONCLUSIONS: The results of this multicenter, double-blind, placebo-controlled, randomized clinical trial demonstrated that an antibody to CD11/CD18 leukocyte integrin receptor did not reduce infarct size in patients who underwent primary angioplasty.
Authors:
David P Faxon; Raymond J Gibbons; Nicolas A F Chronos; Paul A Gurbel; Florence Sheehan;
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  40     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-10-17     Completed Date:  2002-11-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1199-204     Citation Subset:  AIM; IM    
Affiliation:
Los Angeles County Medical Center and the University of Southern California School of Medicine, Los Angeles, California 60637, USA. dfaxon@medicine.bsd.uchicago.edu
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary
Antibodies, Monoclonal / therapeutic use*
Antigens, CD11 / immunology*
Antigens, CD18 / immunology*
Combined Modality Therapy
Coronary Angiography
Double-Blind Method
Electrocardiography
Female
Humans
Integrins / antagonists & inhibitors*
Male
Middle Aged
Myocardial Infarction / diagnosis,  immunology,  mortality,  therapy*
Proportional Hazards Models
Radiopharmaceuticals / diagnostic use
Survival Analysis
Technetium Tc 99m Sestamibi / diagnostic use
Time Factors
Tomography, Emission-Computed, Single-Photon
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antigens, CD11; 0/Antigens, CD18; 0/HU23F2G; 0/Integrins; 0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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