Abstract 14086: Investigation of Inflammatory Markers and Cardiac Events Following Discontinuation of Interleukin-1 Receptor Antagonist in NSTE-ACS Patients
Background: The ILA HEART study demonstrated that administration of IL-1 receptor antagonist (IL-1ra) for 14 days after onset of NSTE-ACS reduced high sensitivity C-reactive protein (hsCRP) at 7 and 14 days, however day 30 hsCRP and 1 year MACE were both increased.
Objectives: To analyze the inflammatory effect of withdrawal of IL-1ra following effective suppression of hsCRP in the context of NSTE-ACS.
Methods and Results: Mixed-model analysis was performed with log hsCRP as dependent variable, day 1 hsCRP as covariate, treatment, day, and treatment/day interaction as fixed effects, and patient as random effect. Mixed-model analysis (Table 1) demonstrates increased hsCRP in the IL-1ra group at day 30 (vrs day 14 IL-1ra, p<0.0001 and vrs day 30 placebo, p=0.0196). Analysis of achieved hsCRP at day 14 demonstrates suppression of hsCRP with IL-1ra in each tertile (Fig 1A). In contrast to the placebo group, withdrawal of IL-1ra results in loss of hsCRP suppression. Within the IL-1ra group hsCRP was higher in patients suffering MACE events (Fig 1B).
Conclusions: Inhibition of IL-1 for 14 days after NSTE-ACS temporarily suppresses CRP. It seems likely that anti-IL-1 therapy will need to be continued for longer after NSTE-ACS.
Author Disclosures: A.M. Rothman: None. A. Morton: None. J. Greenwood: None. J. Gunn: None. A. Chase: None. B. Clarke: None. A. Hall: None. K. Fox: None. C. Foley: None. W. Banya: None. D. Wang: None. M. Flather: None. D.C. Crossman: None.
- © 2015 by American Heart Association, Inc.