Premium
Selective apheresis of C‐reactive protein: A new therapeutic option in myocardial infarction?
Author(s) -
Sheriff Ahmed,
Schindler Ralf,
Vogt Birgit,
AbdelAty Hassan,
Unger Juliane K.,
Bock Christopher,
Gebauer Frank,
Slagman Anna,
Jerichow Timo,
Mans Dörte,
Yapici Gülcan,
Janelt Gunnar,
Schröder Malte,
Kunze Rudolf,
Möckel Martin
Publication year - 2015
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/jca.21344
Subject(s) - medicine , myocardial infarction , ejection fraction , apheresis , cardiology , infarction , c reactive protein , scars , catheter , surgery , platelet , heart failure , inflammation
Background : There is substantial evidence that C‐reactive protein (CRP) mediates secondary damage of the myocardium after acute myocardial infarction (AMI). The aim of this animal trial in pigs was to specifically deplete CRP from porcine plasma after AMI and to study possible beneficial effects of the reduced CRP concentration on the infarcted area. Methods : Ten pigs received balloon catheter‐induced myocardial infarction. CRP was depleted from five animals utilizing a new specific CRP‐adsorber, five animals served as controls. The area of infarction was analyzed by cardiovascular magnetic resonance imaging on day 1 and day 14 after AMI. Porcine CRP levels were determined by ELISA. Results : CRP‐apheresis resulted in a mean reduction of the CRP levels up to 48.3%. The area of infarction was significantly reduced by 30 ± 6% ( P = 0.003) within 14 days in the treatment group, whereas it increased by 19 ± 11% ( P = 0.260) in the controls. Fourteen days after infarction, the infarcted area revealed compact, transmural scars in the controls, whereas animals receiving CRP‐apheresis showed spotted scar morphology. In the interventional group, a significantly higher left ventricular ejection fraction (LVEF) was observed after 14 days as compared to the controls (57.6 ± 2.4% vs. 46.4 ± 2.7%; P = 0.007). Conclusions : In a pig model for AMI, we observed that selective CRP‐apheresis significantly reduces CRP levels and the volume of the infarction zone after AMI. Additionally, it changes the morphology of the scars and preserves cardiac output (LVEF). J. Clin. Apheresis 30:15–21, 2015. © 2014 Wiley Periodicals, Inc.