Drugs in the Pipeline: Original ArticleEffect of IL-1 Blockade With Anakinra on Heart Failure Outcomes in Patients With Anterior Versus Nonanterior ST Elevation Myocardial InfarctionDel Buono, Marco Giuseppe MD*,†; Damonte, Juan Ignacio MD*,‡; Chiabrando, Juan Guido MD*,‡; Markley, Roshanak MD*; Turlington, Jeremy MD*; Trankle, Cory R. MD*; Kang, Le PhD§; Biondi-Zoccai, Giuseppe MD, MStat¶,‖; Van Tassell, Benjamin W. PharmD*,**; Abbate, Antonio MD, PhD*,†† Author Information *VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA; †Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy; ‡Interventional Cardiology Department, Hospital Italiano de Buenos Aires, Argentina; §Department of Biostatistics, Virginia Commonwealth University, Richmond, VA; ¶Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; ‖Mediterranea Cardiocentro, Napoli, Italy; **Department of Pharmacotherapy and Outcomes Sciences, Virginia Commonwealth University, Richmond, VA; and ††Wright Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, VA. Correspondence: Antonio Abbate, MD, PhD, VCU Pauley Heart Center, Virginia Commonwealth University, PO Box 980204, 1200 E Broad St, Richmond, VA 23298-0533 (e-mail: [email protected]). The VCU-ART2 study was supported by an American Heart Association Scientist Development Grant 10SDG 3030051 and a Presidential Research Incentive Program of the Virginia Commonwealth University to A. Abbate and by an Institutional National Institute of Health K12 Award KL2RR031989 to B. W. Van Tassell. The VCU-ART3 study was supported by a grant from the National Institutes of Health (1R34HL121402-01) to A. Abbate and B. W. Van Tassell. Swedish Orphan Biovitrum provided anakinra and matching placebo for VCU-ART3. A. Abbate and B. W. Van Tassell have served as consultants to Swedish Orphan Biovitrum LLC in the past. G. Biondi-Zoccai has consulted for Cardionovum, CrannMedical, InnovHeart, Meditrial, Opsens Medical, and Replycare. The remaining authors report no conflicts of interest. Journal of Cardiovascular Pharmacology: June 2022 - Volume 79 - Issue 6 - p 774-780 doi: 10.1097/FJC.0000000000001240 Buy Corresponding Article Metrics Abstract Patients with ST elevation myocardial infarction (STEMI) are at risk of future heart failure (HF), particularly those with anterior STEMI. Interleukin-1 (IL-1) is a key mediator of the inflammatory response, and its blockade has emerged as a potential therapeutic strategy to prevent HF events. The aim of this analysis was to explore the effects of anakinra, an IL-1 receptor antagonist, on HF outcomes based on anterior versus nonanterior location STEMI and to explore whether this effect is mediated through the amelioration of left ventricular systolic function and cardiac remodeling. We pooled data from 3 early phase randomized clinical trials. The primary end point was a composite of all-cause death and new-onset HF at 1-year follow-up. The left anterior descending coronary artery as culprit vessel was used to identify anterior STEMI. We included 139 patients, 47 (34%) with anterior STEMI and 92 (66%) with nonanterior STEMI. Anakinra significantly reduced the combined end point of death or new-onset HF in patients with anterior STEMI [4 (13%) vs. 7 (42%), log-rank P value = 0.049] and in patients with nonanterior STEMI [3 (6%) vs. 9 (24%), log-rank P value = 0.014]. We found no significant differences comparing anakinra versus placebo in interval changes in left ventricular ejection fraction and volumes in anterior and nonanterior STEMI. In conclusion, anakinra is associated with a reduction of HF events in patients with STEMI, irrespective of anterior or nonanterior location, or of changes in left ventricular ejection fraction or cardiac remodeling. Corresponding Article Targeting Inflammation After Myocardial Infarction—Another Piece of the Puzzle Bromage, Daniel I.; Pareek, Nilesh; Cannata, Antonio; Ameri, Pietro Journal of Cardiovascular Pharmacology. 79(6):769-771, June 2022. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.