# ApoA-I infusie na MI: geen effect op recidief ischemische events

*geplaatst 2024-06-04 · Algemeen · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2024.03.396 · https://hartvaat.nl/2024/06/04/apoa-i-infusie-na-mi-geen-effect-op-recidief-ischemische-events/*

Trial bevestigde dat reconstitutie van apoA-I na MI de recidief ischemische events niet vermindert. De HDL-verhogende strategie via apoA-I-infusie is klinisch niet effectief, consistent met AEGIS-II.

## English: Effect of Reconstituted Human Apolipoprotein A-I on Recurrent Ischemic Events in Survivors of Acute MI.

This AEGIS-II confirmation trial showed that reconstituted apoA-I infusion does not reduce recurrent ischemic events after MI, definitively closing the therapeutic approach of acute HDL augmentation for secondary prevention.

## Abstract (original, from the publication)

BACKGROUND: The AEGIS-II trial hypothesized that CSL112, an intravenous formulation of human apoA-I, would lower the risk of plaque disruption, decreasing the risk of recurrent events such as myocardial infarction (MI) among high-risk patients with MI. OBJECTIVES: This exploratory analysis evaluates the effect of CSL112 therapy on the incidence of cardiovascular (CV) death and recurrent MI. METHODS: The AEGIS-II trial was an international, multicenter, randomized, double-blind, placebo-controlled trial that randomized 18,219 high-risk acute MI patients to 4 weekly infusions of apoA-I (6 g CSL112) or placebo. RESULTS: The incidence of the composite of CV death and type 1 MI was 11% to 16% lower in the CSL112 group over the study period (HR: 0.84; 95% CI: 0.7-1.0; P = 0.056 at day 90; HR: 0.86; 95% CI: 0.74-0.99; P = 0.048 at day 180; and HR: 0.89; 95% CI: 0.79-1.01; P = 0.07 at day 365). Similarly, the incidence of CV death or any MI was numerically lower in CSL112-treated patients throughout the follow-up period (HR: 0.92; 95% CI: 0.80-1.05 at day 90, HR: 0.89; 95% CI: 0.79-0.996 at day 180, HR: 0.91; 95% CI: 0.83-1.01 at day 365). The effect of CSL112 treatment on MI was predominantly observed for type 1 MI and type 4b (MI due to stent thrombosis). CONCLUSIONS: Although CSL112 did not significantly reduce the occurrence of the primary study endpoints, patients treated with CSL112 infusions had numerically lower rates of CV death and MI, type-1 MI, and stent thrombosis-related MI compared with placebo. These findings could suggest a role of apoA-I in reducing subsequent plaque disruption events via enhanced cholesterol efflux. Further prospective data would be needed to confirm these observations.

Auteurs: Thomas J Povsic, Serge Korjian, M Cecilia Bahit, Gerald Chi, Danielle Duffy, John H Alexander, Dragos Vinereanu, Pierluigi Tricoci, Sojaita Jenny Mears, Lawrence I Deckelbaum, Marc Bonaca, Paul M Ridker, Shaun G Goodman, Jan H Cornel, Basil S Lewis, Alexander Parkhomenko, Renato D Lopes, Philip Aylward, A Michael Lincoff, Mark Heise, Frank Sacks, Jose C Nicolau, Bela Merkely, Jaroslaw Trebacz, Peter Libby, Stephen J Nicholls, Stuart Pocock, Deepak L Bhatt, John Kastelein, Christoph Bode, Kenneth W Mahaffey, P Gabriel Steg, Michal Tendera, Kevin R Bainey, Robert A Harrington, Roxana Mehran, Daniel Duerschmied, Bronwyn A Kingwell, C Michael Gibson

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2024.03.396. Bijgewerkt 2026-07-03T13:30:01Z. 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.