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Background: Acute and chronic inflammation influence cardiac healing and remodelling following a myocardial infarction (MI), which may result in heart failure (HF). Numerous pre-clinical studies have reported increased morphological and functional recovery following immune-modulatory interventions. Some clinical trials have been conducted but outcomes have been inconsistent.

Purpose: To assess the benefits of targeting inflammatory cytokines in post-MI patients with heart failure or at high risk of developing HF by performing a systematic review and meta-analysis of clinical trials.

Methods: Clinical trials using cytokine modulation were identified searching PUBMED and clinicaltrials.gov. The search terms: “cytokines”, “interleukin”, “myocardial infarction”, “ventricular remodelling”, “ischemia reperfusion” and “heart failure” were combined with string terms for each intervention using simple Boolean connectors. Inclusion criteria were randomised placebo controlled clinical trials with comparable outcomes, written in English and published in the last 50 years to target immunological factors in patients with, or at risk of developing HF. The selected trials targeted interleukin-1 (IL-1), and tumour necrosis factor-alpha (TNF-α). Trial characteristics were extracted, and assessed for risk of bias. Data of major adverse cardiac events (MACE) including MI and mortality rates were pooled using MedCalc to calculate heterogeneity. Following heterogeneity assessment, a random effects model was implemented. Pooled random effects, p-values and 95% confidence intervals were calculated using the Dersimonian Laird method. The risk ratio (RR) and confidence intervals (CI) for mortality and MACE were calculated.

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Abstracts > Sunday 26 August 2018
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