Fig. 4: Neutrophilia, cardiac injury, and response to anti-inflammatory treatment in acute MI are greater in men than women.

a–e Data from the double-blind ASSAIL-MI (ASSessing the effect of Anti-IL-6 treatment in MI) study. Patients (167 men, 32 women) with first-time ST-elevation MI were randomized to a single dose of the interleukin (IL)-6 receptor inhibitor tocilizumab or placebo prior to percutaneous coronary intervention (PCI). Men placebo; n = 87, men tocilizumab; n = 80, women placebo; n = 11 and women tocilizumab; n = 21. a Illustration of the study protocol. Created in BioRender. Dahl, T. (2024) https://BioRender.com/p48g864b Blood neutrophil counts during the study. c–e Data from cardiac magnetic resonance imaging at 3–7 days (c, d) and 6 months (e) after randomization. LVM left ventricular mass. Bars indicate age-adjusted estimated marginal means, error bars are 95% confidence intervals (CI). Corresponding individual raw data are plotted in Supplementary Fig 9a (for Fig. 4b) and Supplementary Fig 11a–c (for Fig. 4c–e). P values are from two-sided repeated measures ANOVA (b) or ANCOVA (c–e) with LSD post-hoc tests. *P < 0.05, **P < 0.01, ***P < 0.001. Exact p values in post-hoc analyses (WP women placebo, MP men placebo, WT women tocilizumab, and MT men tocilizumab); neutrophil count in blood; 24 h; WP vs MP, P = 0.018, WP vs WT, P = 0.002 and MP vs MT, P < 0.001; 3–7 days; WP vs MP, P = 0.025, WP vs WT, P < 0.001 and MP vs MT, P < 0.001; 3 months; WP vs WT, P = 0.019. c LVM; 3–7 days; WP vs MP, P < 0.001 and WT vs MT, P < 0.001. d MI size; 3–7 days; WP vs MP, P = 0.003, WP vs WT, P = 0.035 and MP vs MT, P = 0.012. e MI size; 6 months; WP vs MP, P = 0.016, MP vs MT, P = 0.012.