Evidence map›Paper›PMID 37591633›Full record

Trial reportOpen heart2023

Cytokine pattern in patients with ST-elevation myocardial infarction treated with the interleukin-6 receptor antagonist tocilizumab.

Sindre Woxholt, T Ueland, Pål Aukrust, Anne Kristine Anstensrud, Kaspar Broch, Ingvild Maria Tøllefsen, Liv Ryan, Bjørn Bendz, Einar Hopp, Nils-Einar Kløw and 10 more

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Open heart, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03004703 (ASSessing the Effect of Anti-IL-6 Treatment in Myocardial Infarction), which is not on this map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03004703 phase2completednot on this map

ASSessing the Effect of Anti-IL-6 Treatment in Myocardial Infarction: The ASSAIL-MI Trial

TypeinterventionalSponsorOslo University HospitalRan2017 to 2021Enrolled200ConditionsCoronary Disease, Myocardial InfarctionArmsTocilizumab, Sodium chloride 0.9%
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Biologics for cardiovascular diseases: from bench to bedside.Signal transduction and targeted therapy · 2026
    Review
  4. Review
  5. Review
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 4 institutions in 1 country.

Sindre WoxholtClinic of Cardiology, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway sindre@woxholt.no.ORCID 0000-0002-8512-9609
T UelandResearch Institute of Internal Medicine, Rikshospitalet University Hospital, Oslo, Norway.
Pål AukrustFaculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Anne Kristine AnstensrudFaculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.ORCID 0000-0003-1499-2402
Kaspar BrochDepartment of Cardiology, Rikshospitalet University Hospital, Oslo, Norway.
Ingvild Maria TøllefsenDepartment of Cardiology, Oslo University Hospital, Oslo, Norway.ORCID 0000-0003-4972-3093
Liv RyanDepartment of clinical and Molecular medicine, Norwegian University of Science and Technology, Trondheim, Norway.
Bjørn BendzFaculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.ORCID 0000-0002-1392-6481
Einar HoppDepartment of Radiology and Nuclear Medicine, Rikshospitalet University Hospital, Oslo, Norway.
Nils-Einar KløwFaculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Ingebjørg SeljeflotFaculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Bente HalvorsenResearch Institute of Internal Medicine, Rikshospitalet University Hospital, Oslo, Norway.
Tuva B DahlResearch Institute of Internal Medicine, Rikshospitalet University Hospital, Oslo, Norway.
Camilla HuseResearch Institute of Internal Medicine, Rikshospitalet University Hospital, Oslo, Norway.
Geir Øystein AndersenDepartment of Cardiology, Oslo universitetssykehus Ulleval, Oslo, Norway.
Lars GullestadFaculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Rune WisethClinic of Cardiology, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway.ORCID 0000-0002-5097-4554
Brage H AmundsenClinic of Cardiology, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway.
Jan Kristian DamasDepartment of Infectious Diseases, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway.
Ola KlevelandClinic of Cardiology, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway.
Oslo University Hospital · NONorwegian University of Science and Technology · NOUniversity of Oslo · NOSt Olav's University Hospital · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTocilizumab improves myocardial salvage index (MSI) in patients with ST-elevation myocardial infarction (STEMI), but its mechanisms of action are unclear. Here, we explored how cytokines were affected by tocilizumab and their correlations with neutrophils, C-reactive protein (CRP), troponin T, MSI and infarct size.

methodsSTEMI patients were randomised to receive a single dose of 280 mg tocilizumab (n=101) or placebo (n=98) before percutaneous coronary intervention. Blood samples were collected before infusion of tocilizumab or placebo at baseline, during follow-up at 24-36, 72-168 hours, 3 and 6 months. 27 cytokines were analysed using a multiplex cytokine assay. Cardiac MRI was performed during hospitalisation and 6 months.

resultsRepeated measures analysis of variance showed significant (p<0.001) between-group difference in changes for IL-6, IL-8 and IL-1ra due to an increase in the tocilizumab group during hospitalisation. IL-6 and IL-8 correlated to neutrophils in the placebo group (r=0.73, 0.68, respectively), which was attenuated in the tocilizumab group (r=0.28, 0.27, respectively). A similar pattern was seen for MSI and IL-6 and IL-8 in the placebo group (r=-0.29, -0.25, respectively) in patients presenting ≤3 hours from symptom onset, which was attenuated in the tocilizumab group (r=-0.09,-0.14, respectively).

conclusionsTocilizumab increases IL-6, IL-8 and IL-1ra in STEMI. IL-6 and IL-8 show correlations to neutrophils/CRP and markers of cardiac injury in the placebo group that was attenuated in the tocilizumab group. This may suggest a beneficial effect of tocilizumab on the ischaemia-reperfusion injury in STEMI patients. TRIAL REGISTRATION NUMBER: NCT03004703.

Indexed as

CytokinesST Elevation Myocardial InfarctionAntibodies, Monoclonal, HumanizedC-Reactive ProteinHumansInterleukin 1 Receptor Antagonist ProteinInterleukin-6Interleukin-8Receptors, Interleukin-6Antibodies, Monoclonal, HumanizedC-Reactive ProteinCytokinesInterleukin 1 Receptor Antagonist ProteinInterleukin-6Interleukin-8Receptors, Interleukin-6tocilizumabBiomarkersInflammationMyocardial InfarctionSTEMI

Identifiers

PMID37591633
PMCPMC10441101
OpenAlexW4385969596

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.