Photo Credit: lawanastudio
The following is a summary of “ApoA-I Infusions and Burden of Ischemic Events After Acute Myocardial Infarction: Insights From the AEGIS-II Trial,” published in the November 2024 issue of Cardiology by Gibson et al.
Patients remain at risk for cardiovascular (CV) events after acute myocardial infarction (AMI). The AEGIS-II trial found CSL112, a human apolipoprotein A-I (ApoA-I), did not significantly reduce CV death, MI, or stroke within 90 days compared to placebo.
Researchers conducted a retrospective study to examine the effect of CSL112 on the total burden of ischemic events and CV death after AMI.
They randomized 18,219 patients with AMI, multivessel coronary artery disease (CAD), and additional CV risk factors to 4 weekly infusions of 6 g CSL112 (n = 9,112) or matching placebo (n = 9,107). A negative binomial regression model estimated the effect of CSL112 compared with placebo on ischemic event rates.
The results showed CSL112 numerically reduced the total events of CV death, MI, and stroke at 90 days (503 vs. 545 events; rate ratio [RR]: 0.88; 95%CI: 0.76-1.03; P=0.11), significantly reduced total events at 180 days (745 vs. 821 events; RR: 0.87; 95% CI: 0.77-0.99; P=0.04), and 365 days (1,120 vs. 1,211 events; RR: 0.89; 95% CI: 0.80-0.99; P=0.04). Subsequent events constituted 13% of events at 90 days, 17% at 180 days, and 22% at 365 days, reductions were also seen in nonfatal MI and CV death. When type II MIs were excluded, CSL112 reduced nonfatal MI (excluding type 2) and CV death at all time points: 90 days (RR: 0.81; 95% CI: 0.68-0.97; P=0.02), 180 days (RR: 0.82; 95% CI: 0.71-0.95; P<0.01), and 365 days (RR: 0.86; 95% CI: 0.76-0.98; P=0.02).
They concluded that CSL112 significantly reduced the total burden of ischemic events and CV death at 180 and 365 days among high-risk patients after AMI.
Source: jacc.org/doi/10.1016/j.jacc.2024.08.001
