Impact of C-reactive protein levels and role of anakinra in patients with ST-elevation myocardial infarction.
Impact of C-reactive protein levels and role of anakinra in patients with ST-elevation myocardial infarction.
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C 反应蛋白水平的影响和阿那白滞素在 ST 段抬高型心肌梗死患者中的作用。
DOI：
10.1016/j.ijcard.2023.131610
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发表时间：
2024
影响因子：
3.5
通讯作者：
Abbate,Antonio
中科院分区：
文献类型：
--
作者：
Moroni,Francesco;Corna,Giuliana;DelBuono,MarcoGiuseppe;Golino,Michele;Talasaz,AzitaH;Decotto,Santiago;Markley,Roshanak;Trankle,Cory;Biondi-Zoccai,Giuseppe;Carbone,Salvatore;Agatiello,CarlaR;VanTassell,Benjamin;Abbate,Antonio
BackgroundInterleukin-1 blockade with anakinra reduces C-reactive protein (CRP) levels and prevents heart failure (HF) events after ST-segment myocardial infarction (STEMI). The effectiveness of anakinra according to the degree of systemic inflammation in STEMI has not been addressed.MethodsWe analyzed 139 patients from three Virginia Commonwealth University Anakinra Response Trial randomized clinical trials to assess whether CRP levels predicted HF hospitalization or death in patients with STEMI, and if CRP levels influenced the effects of treatment with anakinra.ResultsCRP cut-off levels for prediction of the composite of death or HF hospitalization for CRP at admission, 3 and 14 days were, respectively 6.45 mg/L (100% of sensitivity and 66.1% specificity), 26 mg/L (100% of sensitivity and 78% specificity) and 9.56 mg/L (100% of sensitivity and 80% specificity). More patients with elevated CRP levels died or had a HF hospitalization (5/47 [11%] vs 0/82 [0%],p= 0.004 for CRP at admission; 5/32 [15.6%] vs 0/92 [0%],p< 0.001 for day 3 and 5/26 [19%] vs 0/89 [0%], p < 0.001 for day 14). A greater number of patients treated with anakinra had low CRP levels at 3 and 14 days compared to placebo (Odds Ratio 0.11 [95% IC 0.04–0.28],p< 0.0001 and OR 0.35 [95% CI 0.14–0.86],p= 0.02, respectively). Anakinra significantly prevented death or HF hospitalization in patients with high inflammatory burden (p= 0.04 for admission,p= 0.24 for day 3, andp= 0.05 for day 14).ConclusionPatients with elevated CRP had higher incidence of HF hospitalization or death. Anakinra reduced the number of patients with elevated CRP levels and prevented death or HF hospitalization in patients with elevated CRP levels.
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影响因子：
24
作者：
A. Torabi;A. Rigby;J. Cleland
通讯作者：
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影响因子：
39.3
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影响因子：
2.8
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影响因子：
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Abbate, Antonio;Kontos, Michael Christopher;Biondi-Zoccai, Giuseppe
通讯作者：
Biondi-Zoccai, Giuseppe
影响因子：
5.9
作者：
Bursi, Francesca;Weston, Susan A.;Roger, Veronique L.
通讯作者：
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