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Inflammation and atherosclerotic cardiovascular disease: where do we go from here?

Ori Waksman1, Ron Waksman2

  • 1Section of Cardiology.

Current Opinion in Lipidology
|April 17, 2026
PubMed

Insights

Systemic inflammation, measured by high-sensitivity C-reactive protein (hsCRP), drives atherosclerotic cardiovascular disease (ASCVD). This review examines colchicine

Area of Science:

  • Cardiovascular Medicine
  • Inflammation Research
  • Pharmacology

Background:

  • Low-grade systemic inflammation (hsCRP) is a key driver of atherosclerotic cardiovascular disease (ASCVD) and major adverse cardiovascular events (MACE).
  • Colchicine, the first anti-inflammatory agent for secondary cardiovascular prevention, was FDA-approved in 2024, marking a significant translational advance.
  • Recent trials have raised questions about colchicine's efficacy, highlighting the need for alternative anti-inflammatory strategies in ASCVD management.

Purpose of the Study:

  • To provide an updated summary of anti-inflammatory therapies for ASCVD.
  • To review recent key clinical trials, including those involving colchicine, IL-1 antagonists, and IL-6 inhibitors.
  • To explore emerging anti-inflammatory treatments and discuss future clinical trial design considerations.

Main Methods:

  • Literature review of contemporary trials and investigational therapies.
  • Analysis of mechanisms of inflammation in atherosclerosis.
  • Discussion of current and future therapeutic strategies.

Main Results:

  • Recent trials involving colchicine have yielded mixed results, prompting re-evaluation of its role.
  • Interleukin-1 (IL-1) antagonists and interleukin-6 (IL-6) inhibitors are being investigated as alternative anti-inflammatory agents.
  • Understanding inflammation's role in ASCVD is evolving, necessitating updated management approaches.

Conclusions:

  • The efficacy of colchicine in secondary cardiovascular prevention requires further clarification.
  • Novel anti-inflammatory agents targeting specific inflammatory pathways show promise for ASCVD.
  • Future research should focus on refining trial designs to better assess anti-inflammatory therapies in ASCVD.
Abstract

Keywords:
cardiovascular diseasecolchicinehigh-sensitivity C-reactive proteininflammationresidual inflammatory risk

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