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	ISCHAEMIC HEART DISEASE

 
Blocking complement to reduce perioperative risk
To investigate whether inhibiting the pro-inflammatory effects of cytokines might decrease the risk of postoperative events, Verrier et al looked at the effect of a single dose of pexelizumab (a C5 complement inhibitor) on the rates of death or myocardial infarction (MI) 30 days after surgery. In those who had coronary artery bypass graft (CABG) surgery only (2732 patients), no significant difference was found in the rate of events in those receiving pexelizumab (9.8%) versus those receiving placebo (11.8%). However, in the larger population of those who received CABG and artificial valves (3099 patients), 11.5% of those receiving the drug versus 14% of those receiving placebo died or experienced MI (p = 0.03). This effect persisted through to day 180 of follow up. The authors propose that the reduction in events may be mediated by an amelioration of ischaemia–reperfusion injury induced inflammation via terminal complement inhibition.

Verrier ED, Shernan . . . [Full text of this article]