Pexelizumab, an anti-C5 complement antibody, as adjunctive therapy to primary percutaneous coronary intervention in acute myocardial infarction: the COMplement inhibition in Myocardial infarction treated with Angioplasty (COMMA) trial.

摘要: Background— Complement, activated during myocardial ischemia and reperfusion, causes damage through multiple processes. The COMplement inhibition in Myocardial infarction treated with Angioplasty (COMMA) trial was performed to determine the effect of pexelizumab, a C5 complement inhibitor, on infarct size patients ST-segment–elevation (MI) undergoing primary percutaneous coronary intervention. Methods Results— In COMMA, 960 MI (20% isolated inferior MI) were randomized placebo, pexelizumab 2.0-mg/kg bolus, or bolus 0.05-mg/kg per h infusion for 20 hours. Infarct by creatine kinase–MB area under curve, outcome, did not differ significantly between groups (placebo median, 4393; 4526; plus 4713 [ng/mL] · h; P=0.89 versus placebo; P=0.76 placebo), nor composite 90-day death, new worsening heart failure...