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Reperfusion with primary percutaneous coronary intervention (PCI) improves outcomes in patients with ST-segment-elevation MI (STEMI), but tissue perfusion via an intact microvasculature and preservation of myocardium in the ischemic zone also are essential. Complement activation is known to be involved in the inflammatory response to ischemia and reperfusion injury.
Researchers conducted a multinational, manufacturer-funded, placebo-controlled, double-blind, randomized trial of pexelizumab, a C5 complement inhibitor with anti-inflammatory properties, as an adjunct to primary PCI in 5745 STEMI patients. The dose of pexelizumab used — a 2-mg/kg bolus followed by a 0.05-mg/kg/hour infusion for 24 hours — has been shown to produce near-complete …