在 ST 分段升高心肌梗塞的女性和男性中,对用anakinra 阻断介质素-1 的反应
Giuliana Corna1,2, Michele Golino1,3, Azita H Talasaz4
1Division of Cardiology, Department of Internal Medicine, VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA.
Minerva cardiology and angiology
|November 21, 2023
概括
对ST段心肌梗塞 (STEMI) 的Anakinra治疗减少了男性和女性的炎症和心力衰竭事件. 尽管女性的基线炎症较高,但她们从阿纳金拉中获得了类似的益处,这表明其在不同性别的有效性.
科学领域:
- 心脏病学 心脏病学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 用anakinra阻断介质素-1有效降低高灵敏度C反应蛋白 (hsCRP),并预防心力衰竭 (HF) 后ST段心肌梗塞 (STEMI).
- 已知STEMI患者结局的性别差异,但女性与男性对anakinra的特定反应仍然没有特征.
研究的目的:
- 调查以性别为基础的系统性炎症差异,以及在接受anakinra治疗的STEMI患者中新发性HF或死亡的复合终点.
- 评估anakinra在降低hsCRP水平和预防女性和男性STEMI后心血管不良事件方面的疗效.
主要方法:
- 来自三个弗吉尼亚联邦大学阿纳金拉反应试验 (VCUART) 随机临床试验的数据分析.
- 系统性炎症 (hsCRP水平和曲线下的面积) 和新发性HF或死亡的复合终点在亚纳金拉和安慰剂组之间进行的比较,按性别分层.
主要成果:
- 总共分析了139名患者 (21%为女性). 基线hsCRP在女性中明显高于男性.
- 与安慰剂相比,Anakinra治疗数量减少了hsCRP-AUC和HF或死亡的复合终点,无论是男性还是女性.
- 没有观察到女性和男性在对anakinra对hsCRP-AUC或复合终点的反应中存在统计学上显著的差异.
结论:
- 妇女在VCUART试验中代表性不足,并且呈现出更高的基线hsCRP水平.
- 尽管基线炎症较高,但在STEMI中,女性似乎从anakinra治疗中受益得与男性相似.
- 在STEMI后,阿纳金拉在减少炎症和预防两性HF事件方面表现出类似有效性的潜力.
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