# IL-6-receptorremming bij acuut STEMI: gerandomiseerde trial

*geplaatst 2021-04-20 · Algemeen · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2021.02.049 · https://hartvaat.nl/2021/04/20/il-6-receptorremming-bij-acuut-stemi-gerandomiseerde-trial/*

Gerandomiseerde trial van IL-6-receptorremming (tocilizumab) bij acuut STEMI. Anti-inflammatoire benadering bij acuut MI.

## English: Randomized Trial of Interleukin-6 Receptor Inhibition in Patients With Acute ST-Segment Elevation Myocardial Infarction.

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.

## Abstract (original, from the publication)

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).

Auteurs: 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

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2021.02.049. Bijgewerkt 2026-07-03T13:28:17Z. 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.