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An Update on Inflammation in Atherosclerosis: How to Effectively Treat Residual Risk.

N Mohammadnia1, T S J Opstal2, S El Messaoudi1

  • 1Department of Cardiology, Radboudumc, Nijmegen, the Netherlands.

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Targeting inflammation alongside lipid lowering is key for atherosclerotic cardiovascular disease (ASCVD) treatment. Trials show anti-inflammatory drugs improve ASCVD outcomes, addressing residual risk.

Keywords:
Atherosclerotic Cardiovascular DiseaseDisease PreventionInflammationResidual Risk

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Area of Science:

  • Cardiovascular Medicine
  • Inflammation Research
  • Clinical Trials

Background:

  • Inflammation plays a significant role in atherosclerotic cardiovascular disease (ASCVD).
  • Residual risk in ASCVD persists even after optimal lipid-lowering therapy.
  • Emerging research explores novel inflammatory pathways and biomarkers in ASCVD.

Purpose of the Study:

  • To review the contribution of inflammation to ASCVD.
  • To evaluate the impact of recent publications and ongoing trials on atherosclerotic inflammation in clinical care.

Main Methods:

  • Critical review of current literature and ongoing clinical trials.
  • Analysis of key trials investigating anti-inflammatory agents (e.g., canakinumab, colchicine).

Main Results:

  • Trials like CANTOS, COLCOT, and LoDoCo2 demonstrate improved ASCVD outcomes with inflammation suppression.
  • Cholesterol crystals activate the inflammasome, contributing to ASCVD pathogenesis.
  • High-sensitivity C-reactive protein and neutrophil-to-lymphocyte ratio are key biomarkers for residual risk.

Conclusions:

  • Targeting inflammation is crucial for future ASCVD treatment strategies.
  • Ongoing trials will further define the role of anti-inflammatory agents in managing ASCVD.
  • Personalized approaches incorporating inflammation markers may optimize patient care.