Neutrophil Extracellular Traps in ST-Segment Elevation Myocardial Infarction: Reduced by Tocilizumab and Associated With Infarct Size
Authors' conclusion
NETs were reduced by tocilizumab and associated with myocardial injury. The effect of tocilizumab on MSI might be mediated through reduced NETs.
Study context
- Population
- Patients with STEMI randomised during PCI
- Participants
- 199 patients
- Comparison
- Tocilizumab vs placebo
- Primary endpoint
- Blood levels of NET markers (dsDNA, myeloperoxidase-DNA, H3Cit)
- Follow-up
- 3 to 7 days
Primary result
As reported in the abstract
NET markers (dsDNA, myeloperoxidase-DNA, H3Cit)
All NET markers lower with tocilizumab than placebo
all P < 0.04
Further findings
| Outcome | Difference (95% CI) | P value | |
|---|---|---|---|
| MSI, NETs in 3 lowest quartiles vs quartile 43 lowest quartiles vs quartile 4 · dsDNA | 10.9 (4.0–15.0) | P = 0.01 | |
| MSI, NETs in 3 lowest quartiles vs quartile 43 lowest quartiles vs quartile 4 · H3Cit | 8.9 (2.0–15.9) | P = 0.01 | |
| −1001020Difference (linear scale) |
NET-related transcript pathways (subgroup)
- Several NET-related pathways downregulated with tocilizumab
Mediation of tocilizumab effect on myocardial salvage index (MSI) by NET reduction (structural equation modeling)
- Double-stranded deoxyribonucleic acid (dsDNA)
- 0.05, P = 0.001
- H3Cit
- 0.02, P = 0.055
Original publication
Neutrophil Extracellular Traps in ST-Segment Elevation Myocardial Infarction: Reduced by Tocilizumab and Associated With Infarct Size. JACC Adv. Published 15 August 2024. doi:10.
Summarised from the published abstract; every number is checked against it