{"id":"63ce21d20d26","type":"article","url":"https://hartvaat.nl/2021/04/20/il-6-receptorremming-bij-acuut-stemi-gerandomiseerde-trial/","title":"IL-6-receptorremming bij acuut STEMI: gerandomiseerde trial","title_en":"Randomized Trial of Interleukin-6 Receptor Inhibition in Patients With Acute ST-Segment Elevation Myocardial Infarction.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2021.02.049","source_url":"https://doi.org/10.1016/j.jacc.2021.02.049","authors":["Kaspar Broch","Anne Kristine Anstensrud","Sindre Woxholt","Kapil Sharma","Ingvild Maria Tøllefsen","Bjørn Bendz","Svend Aakhus","Thor Ueland","Brage Høyem Amundsen","Jan Kristian Damås","Erlend Sturle Berg","Elisabeth Bjørkelund","Christina Bendz","Einar Hopp","Ola Kleveland","Knut Haakon Stensæth","Anders Opdahl","Nils-Einar Kløw","Ingebjørg Seljeflot","Geir Øystein Andersen","Rune Wiseth","Pål Aukrust","Lars Gullestad"],"significance":7,"published":"2021-04-20","source_date":"2021-04-20","image":"","kennis":[],"congress":"","summary_en":"This randomized trial of tocilizumab (IL-6 receptor inhibitor) in acute STEMI showed reduced C-reactive protein and troponin T release, demonstrating the feasibility and mechanistic promise of anti-inflammatory therapy in the acute MI setting.","created":"2026-07-03T10:29:09Z","updated":"2026-07-03T13:28:17Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Gerandomiseerde trial van IL-6-receptorremming (tocilizumab) bij acuut STEMI. Anti-inflammatoire benadering bij acuut MI.","abstract_original":"BACKGROUND: Prompt myocardial revascularization with percutaneous coronary intervention (PCI) reduces infarct size and improves outcomes in patients with ST-segment elevation myocardial infarction (STEMI). However, as much as 50% of the loss of viable myocardium may be attributed to the reperfusion injury and the associated inflammatory response. OBJECTIVES: This study sought to evaluate the effect of the interleukin-6 receptor inhibitor tocilizumab on myocardial salvage in acute STEMI. METHODS: The ASSAIL-MI trial was a randomized, double-blind, placebo-controlled trial conducted at 3 high-volume PCI centers in Norway. Patients admitted with STEMI within 6 h of symptom onset were eligible. Consenting patients were randomized in a 1:1 fashion to promptly receive a single infusion of 280 mg tocilizumab or placebo. The primary endpoint was the myocardial salvage index as measured by magnetic resonance imaging after 3 to 7 days. RESULTS: We randomized 101 patients to tocilizumab and 98 patients to placebo. The myocardial salvage index was larger in the tocilizumab group than in the placebo group (adjusted between-group difference 5.6 [95% confidence interval: 0.2 to 11.3] percentage points, p = 0.04). Microvascular obstruction was less extensive in the tocilizumab arm, but there was no significant difference in the final infarct size between the tocilizumab arm and the placebo arm (7.2% vs. 9.1% of myocardial volume, p = 0.08). Adverse events were evenly distributed across the treatment groups. CONCLUSIONS: Tocilizumab increased myocardial salvage in patients with acute STEMI. (ASSessing the effect of Anti-IL-6 treatment in Myocardial Infarction [ASSAIL-MI]; NCT03004703)."}