Abstract 14086: Investigation of Inflammatory Markers and Cardiac Events Following Discontinuation of Interleukin-1 Receptor Antagonist in NSTE-ACS Patients

Background: The ILA HEART study demonstrated that administration of IL-1 receptor antagonist (IL-1ra) for 14 days after onset of NSTE-ACS reduced high sensitivity C-reactive protein (hsCRP) at 7 and 14 days, however day 30 hsCRP and 1 year MACE were both increased. Objectives: To analyze the inflammatory effect of withdrawal of IL-1ra following effective suppression of hsCRP in the context of NSTE-ACS. Methods and Results: Mixed-model analysis was performed with log hsCRP as dependent variable, day 1 hsCRP as covariate, treatment, day, and treatment/day interaction as fixed effects, and patient as random effect. Mixed-model analysis (Table 1) demonstrates increased hsCRP in the IL-1ra group at day 30 (vrs day 14 IL-1ra, p<0.0001 and vrs day 30 placebo, p=0.0196). Analysis of achieved hsCRP at day 14 demonstrates suppression of hsCRP with IL-1ra in each tertile (Fig 1A). In contrast to the placebo group, withdrawal of IL-1ra results in loss of hsCRP suppression. Within the IL-1ra group hsCRP was higher in ...