Selective C-reactive protein apheresis in ST-elevation myocardial infarction: Design and rationale of the randomized CRP-STEMI trial - 07/10/25
, Andreas Kronbichler, MD, PhD b, Martin Reindl, MD, PhD a, Christina Tiller, MD, PhD a, Magdalena Holzknecht, MD, PhD a, Fritz Oberhollenzer, MD a, Alex Kaser, MD a, Philipp Gauckler, MD b, Thomas Stiermaier, MD c, d, Hans-Josef Feistritzer, MD, PhD e, Agnes Mayr, MD f, Elke R. Gizewski, MD, MHBA f, Richard Rezar, MD, PhD g, Heiko Bugger, MD h, Kathrin Eller, MD i, Ingo Eitel, MD c, d, Steffen Schneider, PhD j, Gert Mayer, MD b, Holger Thiele, MD e, Axel Bauer, MD a, Bernhard Metzler, MD, MSc a, Ivan Lechner, MD, PhD a, ⁎ on behalf of the
CRP-STEMI Investigators
Highlights |
• | CRP-STEMI is an investigator-initiated, randomized, open-label, multicenter trial. |
• | A total of 202 STEMI patients with elevated CRP post PCI enrolled at 5 centers. |
• | The intervention group receives 3 sessions of selective CRP apheresis post-PCI. |
• | The primary endpoint is infarct size assessed by CMR at 5 ± 2 days after PCI. |
• | CRP-STEMI is the first randomized trial to evaluate CRP apheresis in STEMI. |
ABSTRACT |
Background |
Despite the effectiveness of primary percutaneous coronary intervention (PCI) in treating ST-elevation myocardial infarction (STEMI), myocardial salvage is often incomplete, resulting in large infarct size and an increased risk of heart failure and mortality. Inflammation is involved in this process, with C-reactive protein (CRP) potentially contributing to infarct expansion. Whether selective CRP apheresis in addition to standard care can reduce infarct size in STEMI remains to be determined.
Trial Design |
Selective C-reactive protein apheresis in ST-elevation myocardial infarction (CRP-STEMI) is an investigator-initiated, randomized, open-label (outcome assessor blinded), multicenter trial investigating whether selective CRP apheresis using the PentraSorb-CRP system, in addition to standard care, can reduce infarct size in STEMI patients undergoing PCI within 12 hours of symptom onset. The trial will enroll 202 patients at 5 tertiary care centers in Austria and Germany, randomized 1:1 to either the intervention group (standard care + CRP apheresis) or the control group (standard care). In the intervention group, CRP apheresis will be performed on days 1, 2, and 3 post-PCI. The primary endpoint is infarct size as assessed by late gadolinium enhanced cardiac magnetic resonance at 5 ± 2 days after PCI.
Outlook |
CRP-STEMI is the first randomized trial to investigate whether selective CRP apheresis, as an adjunct to standard care, can effectively reduce infarct size in acute STEMI patients.
Trial Registration |
CRP-STEMI, NCT04939805, is registered at study/NCT04939805.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Plan
Vol 291
P. 1-9 - janvier 2026 Retour au numéro
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