Selective C-reactive protein apheresis in acute myocardial infarction: rationale and design of a prospective international randomized controlled trial.

BACKGROUND

C-reactive protein (CRP) has long been identified as a potential therapeutic target to improve outcomes in acute myocardial infarction (AMI). Recently, CRP apheresis has shown promising results from first-in-human case reports, registries, and pilot trials in patients with COVID-19, acute ST-segment elevation myocardial infarction, cardiogenic shock, and non-ST-segment elevation acute coronary syndromes.

METHODS AND

RESULTS

Herein we describe the perspective for a pivotal, international, randomized controlled trial investigating CRP apheresis in AMI. We herein propose the rationale, design, endpoints, and statistical methodology of this study.

CONCLUSION

The goal is to demonstrate the safety and efficacy of CRP apheresis in AMI in reducing the combined primary clinical endpoint of cardiovascular mortality or rehospitalization for heart failure.