Abstract
BACKGROUND: C-reactive protein (CRP) has long been identified as a potential therapeutic target to improve outcomes in acute myocardial infarction (AMI). Recently, CRP apheresis has shown promising results from first-in-human case reports, registries, and pilot trials in patients with COVID-19, acute ST-segment elevation myocardial infarction, cardiogenic shock, and non-ST-segment elevation acute coronary syndromes. METHODS AND RESULTS: Herein we describe the perspective for a pivotal, international, randomized controlled trial investigating CRP apheresis in AMI. We herein propose the rationale, design, endpoints, and statistical methodology of this study. CONCLUSION: The goal is to demonstrate the safety and efficacy of CRP apheresis in AMI in reducing the combined primary clinical endpoint of cardiovascular mortality or rehospitalization for heart failure.