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Acute coronary disease Athero-Inflammation: Therapeutic approach
1Centro de Trombosis de Buenos Aires and Catedra de Magister en Trombosis, Facultad de Medicina, Universidad Nacional de Tucuman, Argentina. draltman@arnet.com.ar
Insights
Blocking inflammation with anti-inflammatory drugs, like COX-2 inhibitors, may lower the risk of acute coronary events. Early intervention targeting inflammation alongside antithrombotic therapy shows promise for cardiovascular disease prevention.
Area of Science:
- Cardiovascular Medicine
- Inflammation Research
- Pharmacology
Background:
- Antithrombotic therapy is standard for acute coronary syndromes.
- Emerging evidence links inflammation to thrombosis and acute coronary events.
- Athero-inflammation integrates various cardiovascular risk factors like dyslipidemia, diabetes, and hypertension.
Purpose of the Study:
- To explore the potential of anti-inflammatory therapy in preventing cardiovascular events.
- To investigate the role of cyclooxygenase-2 (COX-2) inhibition in managing athero-inflammation.
- To assess the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs), particularly COX-2 inhibitors, in conjunction with aspirin.
Main Methods:
- Review of existing evidence on anti-inflammatory therapy and atherosclerosis.
- Focus on the mechanism of COX-2 inhibition in reducing endothelial inflammation and monocyte infiltration.
- Proposal for large-scale, prospective, double-blind randomized trials.
Main Results:
- Anti-inflammatory strategies, specifically COX-2 inhibition, may reduce endothelial inflammation.
- COX-2 inhibition could improve vascular cell function and plaque stability.
- This approach may lead to a decrease in coronary atherothrombotic events.
Conclusions:
- Targeting inflammation early, in addition to standard antithrombotic therapy, is a potential strategy for acute coronary syndromes.
- COX-2 inhibitors show promise in mitigating athero-inflammatory processes.
- Further clinical trials are warranted to confirm the benefits of NSAIDs, especially COX-2 inhibitors, combined with aspirin.
Abstract:
Antithrombotic therapy is the cornerstone of the treatment of acute coronary syndromes, but there is now evidence which indicates that by blocking inflammation, thrombosis and thus, acute coronary events, could be lowered. The concept of athero-inflammation emerges as the meeting point of different morbidities; dyslipemia, diabetes, hypertension, obesity, immunity, infection, hyperhomocyteinemia, smoking, etc. usual named as risk factors. Thus, beside specific drugs, earliest treatment, in the stage of inflammation, using anti-inflammatory drugs, should be considered since in patients with increased risk of acute coronary process are likely to have many point of origen throughout the coronary arteries. There are a body of evidences for supporting the potential of anti-inflammatory therapy to the prevention of inflammation and atherosclerosis. COX-2 inhibition may decrease endothelial inflammation reducing monocytes infiltration improving vascular cells function, plaque stability and probably resulting in a decrease of coronary atherothrombotic events.Trials including large numbers of patients in prospective double-blind randomized studies worthwhile to confirm the efficacy of NSAID, mainly, COX-2 inhibitors, together with aspirin in the prevention of coronary events in patients with acute coronary disease.