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Anti-inflammatory strategies for patients with atherosclerotic coronary disease

Antonino Imbesi1, Antonio Greco1, Davide Capodanno1

  • 1Division of Cardiology, Azienda Ospedaliero-Universitaria "G. Rodolico-San Marco", University of Catania, Catania, Italy.

Expert Review of Cardiovascular Therapy
|September 18, 2025
PubMed

Insights

Persistent inflammation drives residual cardiovascular risk in atherosclerosis, even with optimal cholesterol reduction. Understanding acute versus chronic inflammation post-myocardial infarction is key for targeted anti-inflammatory therapies.

Area of Science:

  • Cardiovascular Medicine
  • Immunology
  • Inflammation Research

Background:

  • Atherosclerosis, a leading cause of coronary artery disease (CAD), is increasingly recognized as an inflammatory condition, not solely lipid-driven.
  • Despite effective low-density lipoprotein cholesterol (LDL-C) reduction, many patients face residual cardiovascular risk due to persistent inflammation.
  • Understanding the inflammatory processes underlying atherosclerosis progression and plaque destabilization is crucial for improving patient outcomes.

Purpose of the Study:

  • To review the role of inflammation in atherosclerosis and acute myocardial infarction (AMI).
  • To explore emerging biomarkers for cardiovascular risk stratification.
  • To summarize current and investigational anti-inflammatory therapies for CAD.

Main Methods:

  • Comprehensive literature search of PubMed, Web of Science, and Cochrane databases up to July 2025.
  • Analysis of the role of inflammation in plaque progression and destabilization.
  • Review of current and novel anti-inflammatory treatments and risk stratification biomarkers.

Main Results:

  • Inflammation plays a central role in the progression and destabilization of atherosclerotic plaques, leading to acute myocardial infarction (AMI).
  • Emerging biomarkers show promise for improved cardiovascular risk stratification.
  • Current and investigational anti-inflammatory therapies offer potential for managing residual risk, with a focus on differentiating acute vs. chronic post-AMI inflammation.

Conclusions:

  • Anti-inflammatory therapies have advanced cardiovascular prevention, but challenges in patient selection and target identification persist.
  • Novel imaging and AI-driven models are paving the way for personalized anti-inflammatory strategies.
  • Future research should prioritize precision-based approaches targeting detrimental inflammation while preserving beneficial immune responses for maximal clinical benefit.
Abstract

Keywords:
anti-inflammatory therapycolchicineinflammatory biomarkersinterleukin-6lipoprotein(a)perivascular adipose tissueprecision medicineresidual inflammatory risk

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