Leading Article


, Volume 26, Issue 4, pp 217-233

First online:

Blocking Interleukin-1 as a Novel Therapeutic Strategy for Secondary Prevention of Cardiovascular Events

  • Antonio AbbateAffiliated withVCU Pauley Heart Center, Virginia Commonwealth UniversityVictoria Johnson Research Laboratory, Virginia Commonwealth University Email author 
  • , Benjamin W. Van TassellAffiliated withVictoria Johnson Research Laboratory, Virginia Commonwealth UniversitySchool of Pharmacy, Virginia Commonwealth University
  • , Giuseppe G. L. Biondi-ZoccaiAffiliated withDepartment of Medico-Surgical Sciences and Biotechnologies, “Sapienza” University

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The inflammatory hypothesis of atherosclerosis postulates that inflammation within the plaque promotes plaque progression and complications. Interleukin-1 (IL-1) is a key pro-inflammatory cytokine responsible for the amplification of the inflammatory response following injury. Animal studies show that IL-1 blockade is effective in limiting atherosclerosis and atherothrombosis and improving outcomes in acute myocardial infarction and ischemic stroke. Preliminary data in patients with acute myocardial infarction, ischemic stroke, and heart failure are promising. A large secondary prevention trial with canakinumab in patients with prior acute myocardial infarction is currently ongoing. Many unanswered questions remain regarding the optimal use of IL-1 blockade and the preferred agent.