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Inflammation and Cardiovascular Disease: The Future
Natalie Arnold1,2, Katharina Lechner3,4, Christoph Waldeyer1,2
1Department of Cardiology, University Heart and Vascular Center Hamburg Hamburg, Germany.
Insights
Residual risk in atherosclerotic cardiovascular disease (ASCVD) is linked to inflammation. Incorporating inflammation biomarkers into risk assessments may improve prevention strategies for cardiometabolic disease.
Area of Science:
- Cardiovascular Medicine
- Inflammation Research
- Atherosclerosis
Background:
- Conventional risk factor management has reduced atherosclerotic cardiovascular disease (ASCVD) burden, yet significant residual risk persists.
- Low-grade inflammation is a key driver of residual risk and a hallmark of ASCVD, influencing clinical complications.
- Inflammatory processes involve modified lipoproteins and promote a hypercoagulable state.
Purpose of the Study:
- To explore the role of inflammation in atherosclerotic cardiovascular disease (ASCVD) and its clinical implications.
- To evaluate the potential of incorporating inflammation biomarkers into risk stratification for cardiovascular disease prevention.
- To discuss future research directions focusing on the interplay of inflammation, lipid metabolism, and thrombosis in ASCVD.
Main Methods:
- Review of current literature on inflammation, lipid metabolism, and thrombosis in atherosclerotic cardiovascular disease (ASCVD).
- Analysis of the potential benefits of adding inflammation biomarkers to existing risk stratification algorithms.
- Discussion of therapeutic strategies targeting inflammatory burden in high-risk individuals.
Main Results:
- Inflammation is a critical modifier of residual cardiovascular risk, independent of conventional factors.
- Adding inflammation biomarkers to current risk stratification may enhance phenotypic screening and treatment guidance.
- Interventions targeting inflammation, alone or combined with lipid-modifying or antithrombotic agents, show promise for reducing cardiometabolic disease burden.
Conclusions:
- Inflammation plays a pivotal role in atherosclerotic cardiovascular disease (ASCVD) pathogenesis and clinical outcomes.
- Integrating inflammation markers into risk assessment can refine cardiovascular disease prevention strategies.
- Future research should focus on translating the understanding of inflammation, lipid, and thrombosis interactions into clinical practice.
Abstract:
Despite considerable advances in reducing the global burden of atherosclerotic cardiovascular disease by targeting conventional risk factors, significant residual risk remains, with low-grade inflammation being one of the strongest risk modifiers. Inflammatory processes within the arterial wall or systemic circulation, which are driven in a large part by modified lipoproteins but subsequently trigger a hypercoagulable state, are a hallmark of atherosclerotic cardiovascular disease and, in particular, its clinical complications. Extending conventional guideline-based clinical risk stratification algorithms by adding biomarkers of inflammation may refine phenotypic screening, improve risk stratification and guide treatment eligibility in cardiovascular disease prevention. The integration of interventions aimed at lowering the inflammatory burden, alone or in combination with aggressive lipid-modifying or even antithrombotic agents, for those at high cardiovascular risk may hold the potential to reduce the still substantial burden of cardiometabolic disease. This review provides perspectives on future clinical research in atherosclerosis addressing the tight interplay between inflammation, lipid metabolism and thrombosis, and its translation into clinical practice.
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