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This Week in JAMA
January 3, 2007

This Week in JAMA

JAMA. 2007;297(1):9. doi:10.1001/jama.297.1.9

Among patients with acute ST-elevation myocardial infarction (STEMI) who are treated with percutaneous coronary intervention (PCI), a postreperfusion inflammatory response has been associated with subsequent mortality. In an experimental model, pexelizumab, a humanized monoclonal antibody that binds the C5 component of complement, reduced inflammation and infarct size and possible reductions in mortality were observed in early clinical studies of patients undergoing PCI with pexelizumab. The randomized, placebo-controlled Assessment of Pexelizumab in Acute Myocardial Infarction Trial (APEX AMI) was designed to assess whether pexelizumab as an adjunct to PCI could improve outcomes after STEMI. The trial investigatorsArticle report that there were no differences between the pexelizumab and placebo treatment groups in 30-day or 90-day all-cause mortality or in a composite outcome of death, cardiogenic shock, or congestive heart failure. In an editorial, Eikelboom and O’DonnellArticle discuss the APEX AMI trial, possible explanations for the lack of demonstrated benefit from adjunctive pexelizumab therapy, and implications for future research.