ClinicalTrials.gg
RecruitingNCT04939805Updated Oct 7, 2026

CRP Apheresis in STEMI

An interventional study of Selective CRP apheresis using the PentraSorb®-CRP system in ST Elevation Myocardial Infarction, C-Reactive Protein and Apheresis, sponsored by Medical University Innsbruck. Recruiting at 5 sites in 2 countries. Open to participants aged 18 Years to 85 Years. Per ClinicalTrials.gov, last updated 2026-10-07.

Sponsored by Medical University Innsbruck · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Apr 2021; still recruiting 5 years 7 months later.
Updated Oct 7, 2026Primary completion movedStudy completion movedGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
202
Allocation
Randomized
Ages
18 Years to 85 Years
Sex
All
01

Study summary

Background: In patients with acute ST-elevation myocardial infarction (STEMI), the amount of infarcted myocardium (infarct size) is known to be a major predictor for adverse remodeling and recurrent adverse cardiovascular events. Effective cardio-protective strategies with the aim of reducing infarct size are therefore of great interest. Local and systemic inflammation influences the fate of ischemic myocardium and thus, adverse remodeling and clinical outcome. C-reactive protein (CRP) also acts as a potential mechanistic mediator that adversely affects the amount of irreversible myocardial tissue damage after acute myocardial infarction.

Objective: The main objectives of the current study are to investigate the efficacy of selective CRP apheresis, using the PentraSorb®-CRP system, as an adjunctive therapy to standard of care for patients with acute STEMI treated with primary PCI.

Design: Investigator-initiated, prospective, randomized, open-label (outcome assessors masked), controlled, multicenter, two group trial with a two-stage adaptive design.

Innovation: Selective CRP apheresis offers potential to decrease infarct size and consequently improve outcome after PCI for STEMI. This is the first randomized trial investigating the impact of selective CRP apheresis on infarct size in post-STEMI patients. In perspective, the study design allows furthermore to collect robust evidence for the design of a definitive outcome study.

02

Conditions studied

  • ST Elevation Myocardial Infarction
  • C-Reactive Protein
  • Apheresis
  • Myocardial Injury

Keywords

  • Cardiac magnetic resonance imaging
03

In context

ST Elevation Myocardial Infarction

850 studies on the registry are indexed under ST Elevation Myocardial Infarction; 197 are open to participants now.

This study's planned enrollment of 202 is close to the median of 194 across 527 interventional studies indexed under ST Elevation Myocardial Infarction.

Browse ST Elevation Myocardial Infarction studies →

Lead sponsor

Medical University Innsbruck is the lead sponsor of 186 studies on the registry; 47 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 85 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Diagnosis of first acute STEMI in accordance with the European Society of Cardiology (ESC) Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation
  2. Symptoms consistent with STEMI with beginning greater than 30 minutes but less than 12 hours prior to primary percutaneous coronary intervention (PCI)
  3. CRP elevation of ≥7 mg/l measured between 6 to 16 hours after primary PCI
  4. Eligible for primary PCI
  5. Age ≥18 years
  6. Written

Exclusion criteria

Exclusion Criteria:

  1. Prior acute myocardial infarction, coronary artery bypass surgery or PCI.
  2. Persistent hemodynamic instability (Killip class >2 including cardiogenic shock) or resuscitated cardiac arrest not allowing a CMR scan.
  3. The patient is febrile (temperature >38°C) or has experienced an acute infection with fever in the last 14 days.
  4. CRP >15 mg/l at time of hospital admission.
  5. Chronic inflammatory disease.
  6. Known history of severe hepatic failure
  7. Chronic kidney disease with a \<30ml/min./1.73m²
  8. to CMR.
  9. Pre-STEMI of \<1 year
  10. Participation in another interventional trial
  11. Limited possibility to join the follow-up examinations (e.g. patient lives abroad)
  12. Pregnancy
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
202 participants (estimated)

Study arms

  • Experimental
    Selective CRP apheresis as an adjunct to standard of care

    Apheresis using the PentraSorb®-CRP system will be performed at day 1, 2 and 3 after PCI.

    Device: Selective CRP apheresis using the PentraSorb®-CRP system

  • No intervention
    Standard of care according to current guideline recommendations

Interventions

  • DeviceSelective CRP apheresis using the PentraSorb®-CRP system

    Selective CRP apheresis as an adjunct to standard of care. Apheresis using the PentraSorb®-CRP system will be performed at day 1, 2 and 3 after PCI.

06

What researchers measure

Primary outcomes

  1. Primary efficacy endpoint

    Infarct size expressed as % of left ventricular myocardial mass (LVMM) as visualized by cardiac magnetic resonance (CMR) imaging at 5 ± 2 days post PCI

    Time frame: 5 ± 2 days post PCI

Secondary outcomes

  1. Safety endpoint

    Adverse events according to Common Terminology Criteria for Adverse Events (CTCAE) during hospitalization for the index event

    Time frame: during hospitalization for the index event

  2. All-cause mortality or hospitalization for heart failure within 12 months after randomization

    All-cause mortality or hospitalization for heart failure within 12 months after randomization (endpoint of interest with respect to the two-stage adaptive design)

    Time frame: within 12 months after randomization

  3. CMR endpoints defined as: Left ventricular ejection fraction and microvascular obstruction and exploratory (intramyocardial hemorrhage, edema extent, myocardial salvage, native T1 mapping, strain)

    CMR endpoints will be assessed at baseline, 4 and 12 months CMR follow-up study and are defined according to the Journal of American College of Cardiology Scientific Expert Consensus document.

    Time frame: at baseline, 4 months and 12 months after PCI for STEMI

  4. Hospitalization for heart failure within 12 months after randomization

    Time frame: within 12 months after randomization

  5. Cardiovascular mortality at 12 months

    Time frame: within 12 months after randomization

  6. CRP concentrations

    CRP concentrations during index hospitalization

    Time frame: during hospitalization for the index event

  7. Left ventricular thrombus formation

    Time frame: 5 ± 2 days, 4 months, 12 months post PCI

  8. Biomarker concentrations of myocardial necrosis (enzymatic infarct size; high-sensitivity troponin T)

    Time frame: at baseline, 4 months, 12 months post PCI

  9. Biomarker concentrations of hemodynamic stress (N-terminal pro-B-Type Natriuretic Peptide)

    Time frame: at baseline, 4 months, 12 months post PCI

  10. Renal function (eGFR)

    as measured by the MDRD and CKD-EPI formula

    Time frame: during hospitalization for the index event

  11. Renal function (Cystatin C-based calculation of creatinine clearance)

    Time frame: during hospitalization for the index event

  12. Cardiac autonomic function: Deceleration capacity of heart rate

    Time frame: 5 ± 2 days, 4 months, 12 months post PCI

  13. Cardiac autonomic function: Heart rate variability

    Time frame: 5 ± 2 days, 4 months, 12 months post PCI

  14. Cardiac autonomic function: Periodic repolarization dynamics

    Time frame: 5 ± 2 days, 4 months, 12 months post PCI

  15. Cardiac autonomic function: Baroreflex sensitivity

    Time frame: 5 ± 2 days, 4 months, 12 months post PCI

  16. Cardiac autonomic function: Skin sympathetic nerve activity

    Time frame: 5 ± 2 days, 4 months, 12 months post PCI

07

Study locations

3 of 5 sites recruiting
  • University Clinic for Cardiology and Nephrology, Medical University of Graz
    Graz, 8036, Austria
    Recruiting
    • Heiko Bugger, MD · Contact
    • Heiko Bugger, MD · Principal investigator
    • Kathrin Eller, MD · Sub investigator
  • University Clinic of Internal Medicine III, Cardiology and Angiology. University Clinic of Internal Medicine IV, Nephrology and Hypertensiology. University Clinic of Radiology.
    Innsbruck, 6020, Austria
    Recruiting
    • Sebastian J Reinstadler, MD, PhD · Contactsebastian.reinstadler@gmail.com
    • Gert Klug, MD · Sub investigator
    • Andreas Kronbichler, MD, PhD · Sub investigator
    • Agnes Mayr, MD · Sub investigator
    • Martin Reindl, MD, PhD · Sub investigator
    • Ivan Lechner, MD · Sub investigator
    • Christina Tiller, MD · Sub investigator
    • Magdalena Holzknecht, MD · Sub investigator
    • Philipp Gauckler, MD · Sub investigator
    • Sara Denicolò, MD · Sub investigator
    • Bernhard Metzler, MD, MSc · Sub investigator
    • Axel Bauer, MD · Sub investigator
    • Gert Mayer, MD · Sub investigator
    • Elke Gizewski, MD · Sub investigator
  • University Clinic of Internal Medicine II, Paracelsus Medical University Salzburg
    Salzburg, 5020, Austria
    Not yet recruiting
    • Lukas J Motloch, MD, PhD · Contact
    • Lukas J Motloch, MD, PhD · Principal investigator
  • Medical Clinic II - University Heart Center Lübeck
    Lübeck, Schleswig-Holstein 23538, Germany
    Not yet recruiting
    • Thomas Stiermaier, MD · Contact
    • Ingo Eitel, Prof. · Principal investigator
    • Thomas Stiermaier, MD. · Sub investigator
  • Leipzig Heart Center
    Leipzig, 04289, Germany
    Recruiting
    • Hans-Josef Feistritzer, MD, PhD · Contact
    • Holger Thiele, MD · Principal investigator
    • Hans-Josef Feistritzer, MD, PhD · Sub investigator
08

References and documents

Publications

  • Reinstadler SJ, Kronbichler A, Reindl M, Tiller C, Holzknecht M, Oberhollenzer F, Kaser A, Gauckler P, Stiermaier T, Feistritzer HJ, Mayr A, Gizewski ER, Rezar R, Bugger H, Eller K, Eitel I, Schneider S, Mayer G, Thiele H, Bauer A, Metzler B, Lechner I; CRP-STEMI Investigators. Selective C-reactive protein apheresis in ST-elevation myocardial infarction: Design and rationale of the randomized CRP-STEMI trial. Am Heart J. 2026 Jan;291:1-9. doi: 10.1016/j.ahj.2025.07.067. Epub 2025 Jul 28. PubMed 40738310 ↗
09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedDate before it movedWhere the date was before it movedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Apr 2021 to primary completion in Jan 2026, 57 months.

Of 134 non-industry interventional studies with no phase under ST Elevation Myocardial Infarction, half reached primary completion within 38 months of starting (the median), counting those still running; a quarter within 19 and three quarters within 64. This study's 57 months is above that.

Counting every sponsor, half of 143 studies reached it within 38 months; a quarter within 19 and three quarters within 64.

Since we started tracking on Sep 25, 2026, the dates moved once, on Oct 7, 2026: primary completion Aug 2025 → Jan 2026 and completion Aug 2025 → Dec 2026.

Earlier changes are on the record history on ClinicalTrials.gov ↗

How these figures are worked out, and which studies are left out of them.

Registered
Jun 7, 2021
First posted
Jun 25, 2021
StartActual
Apr 1, 2021
Primary completionActual
Jan 28, 2026was Aug 2025
CompletionEst.
Dec 15, 2026was Aug 2025
Last update
Oct 7, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Primary completion
Aug 31, 2025→Jan 28, 2026 (actual)
Oct 7, 2026
Study completion
Aug 31, 2025→Dec 15, 2026
Oct 7, 2026
Publications
1 publication citing this study linked from PubMed, e.g. PubMed 40738310 ↗
Oct 7, 2026
Show all 1 update
  1. Oct 7, 2026
    Publications 1 publication citing this study linked from PubMed, e.g. PubMed 40738310 ↗
    Primary completion Aug 31, 2025→Jan 28, 2026 (now actual)
    Study completion Aug 31, 2025→Dec 15, 2026
    + 3 other changes: index terms, verification date and site details

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT04939805
Responsible party
Sponsor
First posted
Jun 25, 2021
Start date
Apr 1, 2021
Primary completion
Jan 28, 2026
Completion
Dec 15, 2026 (estimated)
Last update
Oct 7, 2026

Study contacts

Sebastian J Reinstadler, MD, PhD
Contact
sebastian.reinstadler@gmail.com
+43 (0) 512 504 25665
Ivan Lechner, MD, PhD
Contact
ivan.lechner@tirol-kliniken.at
+43 (0) 512 504 25665
Sebastian J Reinstadler, MD, PhD
principal investigator · University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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