[Atherosclerosis and inflammation: no longer just theory, but a real perspective.]

Coronary atherosclerotic disease is still one of the leading causes of death worldwide. Despite the changes of lifestyle and therapeutic treatments, there is an individual residual risk as worthy of further study. Investigating the residual risk means knowing its pathophysiological mechanisms, developing imaging techniques and biomarkers capable of identifying patients who can benefit from new available treatments. It is known that in all phases of the atherosclerotic process a pivotal role is played by inflammation, which, through innate and adaptive immunity, determines many direct and indirect effects which affect the patient's prognosis. The most immediate and least expensive way to stratify the patient's inflammatory risk is a dosage of high-sensitivity C-reactive protein (hs-CRP). The hs-CRP reduction and cardiovascular events observed with the use of lipid-lowering drugs (statins), in treatments aimed at modulating the inflammatory system in the treatment of rheumatological pathologies, has paved the way for studies with drugs in the rheumatological therapeutic arena in the cardiovascular setting. The results, in addition to confirming an improvement in the main cardiovascular hard endpoints, allowed a refinement of knowledge by identifying increasingly precise targets and reducing potential side effects. Ongoing and future studies are creating solid scientific evidence in which the optimal control of inflammation will be an essential therapeutic target.