Interplay between inflammation and thrombosis in cardiovascular pathology

Area of Science:

• Cardiovascular Medicine
• Immunology
• Hematology

Background:

• Thrombosis is a leading cause of death, with current antithrombotic therapies posing bleeding risks and failing to prevent all events.
• Inflammation's role in thrombosis, termed immunothrombosis, is increasingly recognized as a critical, yet inadequately addressed, mechanism in cardiovascular diseases.
• Aberrant immunothrombosis, or thromboinflammation, links inflammatory conditions and infections (like COVID-19) to increased cardiovascular event risk.

Purpose of the Study:

• To review the synergistic relationship between inflammation and thrombosis in driving cardiovascular pathologies.
• To highlight the therapeutic potential of anti-inflammatory strategies in addressing the limitations of current antithrombotic treatments.
• To emphasize the concept of immunothrombosis and its clinical relevance in thromboembolic diseases.

Main Methods:

• Review of recent findings on the connection between innate immunity, platelet activation, and coagulation.
• Analysis of clinical trial data supporting the efficacy of anti-inflammatory strategies in cardiovascular diseases.
• Discussion of the mechanism of immunothrombosis and its role in thromboinflammation.

Main Results:

• Inflammation and thrombosis are intricately linked, driving cardiovascular diseases through a process called immunothrombosis.
• Anti-inflammatory strategies have demonstrated anti-ischaemic effects, confirming inflammation's prothrombotic function.
• Targeting inflammation offers a promising approach to prevent thrombosis with a reduced risk of bleeding compared to traditional antithrombotics.

Conclusions:

• Aberrant immunothrombosis, or thromboinflammation, is a key driver of cardiovascular events like myocardial infarction and stroke.
• Anti-inflammatory therapies represent a crucial strategy to fill the therapeutic gap left by current antithrombotic treatments.
• Targeting inflammation to prevent thrombosis preserves hemostasis, thereby circumventing the bleeding complications associated with existing therapies.