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Cited by 65Atherosclerosis and Cardiovascular DiseasesLipoproteins and Cardiovascular HealthAntiplatelet Therapy and Cardiovascular Diseases

Targeting Inflammation to Reduce Residual Cardiovascular Risk

Ajala, Oluremi N., Everett, Brendan M.·2020·Current Atherosclerosis Reports
DOI 10.1007/s11883-020-00883-3
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Abstract

Purpose of review Patients with established cardiovascular disease are at high risk for recurrent myocardial infarction, stroke, and cardiovascular death. The term residual risk refers to this risk that persists, even after optimal treatment. Considerable progress has been made to understand the biological basis of residual risk and to devise therapies that can safely and effectively reduce risk. The presence of ongoing subclinical vascular inflammation is known to be a marker of elevated residual risk, and reductions in measures of vascular inflammation predict improved outcome in these patients. Recent findings Recent trials of anti-inflammatory agents have specifically tested the hypothesis that inflammation reduction reduces residual cardiovascular risk. Most prominent among these are the CANTOS, COLCOT, and CIRT trials. CANTOS enrolled patients with prior myocardial infarction (MI) and a high-sensitivity C-reactive protein ≥ 2 mg/L and reported a 15% reduction in major adverse cardiovascular events (MACE; HR 0.85, 95% CI 0.74-0.98) with the interleukin-1β inhibitor canakinumab. In COLCOT, colchicine 0.5 mg daily led to a 23% relative risk reduction (HR 0.77, 95% CI 0.61-0.96) in major vascular events in patients with recent acute coronary syndrome. By contrast, CIRT was stopped early for lack of benefit of low-dose methotrexate in preventing MACE in patients with coronary artery disease and either type 2 diabetes or the metabolic syndrome. Ongoing subclinical inflammatio…

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Crossref · 10.1007/s11883-020-00883-3

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Authors
Ajala, O. N., & Everett, B. M.
Affiliations
Brigham and Women's Hospital (US)
Corresponding author
Everett, Brendan M.
ORCID
Everett, Brendan M.
Venue
Current Atherosclerosis Reports
Publisher
Springer Science and Business Media LLC
Published
2020-09-03
Volume
22
Issue
11
Pages
66-66
ISSN
  • 1523-3804 (ISSN-L)
  • 1534-6242
DOI
10.1007/s11883-020-00883-3
OpenAlex
W3083430288
Cited by
65
References
15
Citations by year
2026: 6 · 2025: 16 · 2024: 12 · 2023: 8 · 2022: 11 · 2021: 7 · 2020: 5
FWCI
0.76
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Current Atherosclerosis Reports (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Heart, Lung, and Blood Institute (HL007575, HL134810)
Topics
  • Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
Keywords
residual cardiovascular risk, vascular inflammation, anti-inflammatory therapy, canakinumab, IL-1β inhibition, colchicine, methotrexate, CANTOS trial, high-sensitivity C-reactive protein, major adverse cardiovascular events, acute coronary syndrome, coronary artery disease, type 2 diabetes, metabolic syndrome, reinfarction, stroke
MeSH terms
Heart Disease Risk Factors, Anti-Inflammatory Agents, C-Reactive Protein, Cardiovascular Diseases, Colchicine, Diabetes Mellitus, Type 2, Humans, Vasculitis, Treatment Outcome, Metabolic Syndrome, Interleukin-1beta, Antibodies, Monoclonal, Humanized

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