Key result
Anakinra is linked to lower acute inflammation and fewer HF events regardless of CAD complexity.
Why the study?
Patients with STEMI and complex CAD face a poor prognosis, but data on the effects of anakinra based on CAD complexity are lacking.
Does anakinra reduce hsCRP-AUC and the composite of new-onset HF, HF hospitalization, or all-cause death in patients with STEMI across the spectrum of CAD complexity?
Does anakinra reduce hsCRP-AUC and the composite of new-onset HF, HF hospitalization, or all-cause death in patients with STEMI across the spectrum of CAD complexity?
Anakinra attenuates the acute inflammatory response and reduces the risk of heart failure-related events in STEMI patients regardless of baseline coronary artery disease complexity.
Anakinra may attenuate inflammation and HF risk across CAD complexities in STEMI; leaves open prospective confirmation in larger trials.
Patients with ST-segment elevation myocardial infarction (STEMI) and complex coronary artery disease (CAD) face a poor prognosis, including increased heart failure (HF) risk. Phase 2 clinical trials of anakinra have shown inhibition of the acute inflammatory response and prevention of HF after STEMI, but data on its effects based on CAD complexity are lacking. We performed a pooled secondary analysis of 139 patients with STEMI. The SYNTAX (Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery), SYNTAX II, and Gensini scores were calculated, and patients were divided into 2 groups below and above the median. We evaluated the effect of anakinra on the area-under-the-curve of high-sensitivity C-reactive protein (hsCRP-AUC) at 14 days, and the composite endpoint of new-onset HF, HF hospitalization, or all-cause death at 1-year follow-up using Kaplan-Meier survival curves, Cox regression analysis for hazard ratios (HRs), and tested interactions between subgroups. All 3 CAD complexity scores (SYNTAX, SYNTAX II, and Gensini) were associated with an increased risk of adverse events (HR 1.02-1.06, all P-values ≤0.025). We found no statistically significant interactions between CAD extent, measured as single-vessel or multivessel CAD, SYNTAX score ≤9 or >9, SYNTAX II score ≤24 or >24, Gensini score ≤32 or >32, and treatment effect of anakinra on hsCRP-AUC or the composite clinical endpoint (all P - values for interaction >0.05). In conclusion, among patients with STEMI, IL-1 blockade with anakinra significantly attenuated the acute inflammatory response and reduced the risk of HF-related events regardless of the spectrum of CAD complexity.
No takes yet. Share an insight, caveat, or question.
Denicolai et al. (2024) studied ST-segment elevation myocardial infarction (STEMI) (n=139). Anakinra was evaluated on Area-under-the-curve of high-sensitivity C-reactive protein (hsCRP-AUC) at 14 days, and composite of new-onset HF, HF hospitalization, or all-cause death at 1 year (p=>0.05). IL-1 blockade with anakinra significantly attenuated the acute inflammatory response and reduced the risk of HF-related events regardless of CAD complexity (P>0.05 for interaction).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: