Rituximab in Patients With Acute ST-elevation Myocardial Infarction Study

Inclusion criteria

• Age 18-75 years old
• Acute anterior (left anterior descending artery) STEMI and successful primary percutaneous coronary intervention (PCI) with stent implantation in the culprit lesion during the first 24h after onset of symptoms

Exclusion criteria

• A previous history of STEMI
• Cardiogenic shock (systolic blood pressure <80 mm Hg, unresponsive to fluids, or necessitating catecholamines), electrical instability or severe congestive heart failure
• Residual severe proximal bystander disease awaiting inpatient revascularisation
• Corrected QT interval (QTc) > 500 msecs using Bazett's formula
• Hematologic abnormalities (hemoglobin <10 g/dL or hematocrit <30%, platelet cell count of <100 x103/μL, white blood cell count <4 x103/μL)
• Hypogammaglobulinaemia (defined as <3g/L of IgG)
• Renal failure (estimated GFR by the MDRD formula < 45 ml/min/1.73m2);
• Known hepatic failure or abnormal liver function tests at baseline (ALT > 2 x ULN).
• Active or recurrent hepatitis (type B).
• Known HIV infection
• Current or previous tuberculosis (Chest X-Ray)
• Current infections
• Presence or history in the previous five years of an ongoing cancer, except in situ cancer of the cervix or basal cell carcinoma
• Any oral or intravenous immunosuppressive treatment (other than concomitant 100 mg methylprednisolone), disease modifying drugs, or other immune modulatory monoclonal antibodies or immunodepleting therapy at any time
• Allergy to rituximab or one of its excipients
• Expected need for vaccination with a live attenuated vaccine during the study including incomplete vaccination courses.
• Known or suspected pregnancy at screening or lactating woman
• Women of childbearing age unless confirmed by direct questioning that they are reproductively sterile or post-menopausal
• Participation in other clinical trials
• Inability to comply with study procedures