Effects of interleukin-1 blockade with anakinra on adverse cardiac remodeling and heart failure after acute myocardial infarction [from the Virginia Commonwealth University-Anakinra Remodeling Trial (2) (VCU-ART2) pilot study].
Effects of interleukin-1 blockade with anakinra on adverse cardiac remodeling and heart failure after acute myocardial infarction [from the Virginia Commonwealth University-Anakinra Remodeling Trial (2) (VCU-ART2) pilot study].
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白介素-1用Anakinra封锁对急性心肌梗死后心脏不良心脏重塑和心力衰竭的影响[弗吉尼亚州英联邦大学 - 阿纳基纳拉重塑试验（2）（VCU-ART2）试验研究]。
DOI：
10.1016/j.amjcard.2013.01.287
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发表时间：
2013-05-15
影响因子：
2.8
通讯作者：
Vetrovec, George Wayne
中科院分区：
文献类型：
--
作者：
Abbate, Antonio;Van Tassel, Benjamin Wallace;Biondi-Zoccai, Giuseppe;Kontos, Michael Christopher;Grizzard, John Dallas;Spillman, Debra Whittaker;Oddi, Claudia;Roberts, Charlotte Susan;Melchior, Ryan David;Mueller, George Herman;Abouzaki, Nayef Antar;Rengel, Lenore Rosemary;Varma, Amit;Gambill, Michael Lucas;Falcao, Raquel Appa;Voelkel, Norbert Felix;Dinarello, Charles Anthony;Vetrovec, George Wayne
Acute myocardial infarction (AMI) initiates an intense inflammatory response in which interleukin-1 (IL-1) plays a central role. The IL-1 receptor antagonist is a naturally occurring antagonist, and anakinra is the recombinant form used to treat inflammatory diseases. The aim of the present pilot study was to test the safety and effects of IL-1 blockade with anakinra on left ventricular (LV) remodeling after AMI. Ten patients with ST-segment elevation AMI were randomized to either anakinra 100 mg/day subcutaneously for 14 days or placebo in a double-blind fashion. Two cardiac magnetic resonance (CMR) imaging and echocardiographic studies were performed during a 10- to 14-week period. The primary end point was the difference in the interval change in the LV end-systolic volume index (LVESVi) between the 2 groups on CMR imaging. The secondary end points included differences in the interval changes in the LV end-diastolic volume index, and C-reactive protein levels. A +2.0 ml/m2 median increase (interquartile range +1.0, +11.5) in the LVESVi on CMR imaging was seen in the placebo group and a –3.2 ml/m2 median decrease (interquartile range –4.5, –1.6) was seen in the anakinra group (p = 0.033). The median difference was 5.2 ml/m2. On echocardiography, the median difference in the LVESVi change was 13.4 ml/m2 (p = 0.006). Similar differences were observed in the LV end-diastolic volume index on CMR imaging (7.6 ml/m2, p = 0.033) and echocardiography (9.4 ml/m2, p = 0.008). The change in C-reactive protein levels between admission and 72 hours after admission correlated with the change in the LVESVi (R =+0.71, p = 0.022). In conclusion, in the present pilot study of patients with ST-segment elevation AMI, IL-1 blockade with anakinra was safe and favorably affected by LV remodeling. If confirmed in larger trials, IL-1 blockade might represent a novel therapeutic strategy to prevent heart failure after AMI.
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影响因子：
20.1
作者：
Frangogiannis NG
通讯作者：
Frangogiannis NG
影响因子：
6.8
作者：
Abbate, Antonio;Van Tassell, Benjamin W.;Biondi-Zoccai, Giuseppe G. L.
通讯作者：
Biondi-Zoccai, Giuseppe G. L.
影响因子：
3
作者：
Van Tassell, Benjamin W.;Varma, Amit;Abbate, Antonio
通讯作者：
Abbate, Antonio
影响因子：
37.8
作者：
Pearson, TA;Mensah, GA;Vinicor, F
通讯作者：
Vinicor, F
影响因子：
39.3
作者：
Orn, Stein;Manhenke, Cord;Dickstein, Kenneth
通讯作者：
Dickstein, Kenneth