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Update on the Inflammatory Hypothesis of Coronary Artery Disease

  • Ischemic Heart Disease (D Mukherjee, Section Editor)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The pathogenesis and progression of coronary artery disease (CAD) is now known to be largely driven by inflammation on top of the well-accepted role for the disequilibrium between cholesterol deposition and removal from the arterial wall. Recent clinical trials have supported the inflammatory hypothesis of CAD and will be discussed in this review.

Recent Findings

The clinical trial Canakinumab Anti-inflammatory Thrombosis Outcomes Study (CANTOS) found that treatment with canakinumab, an anti-interleukin-1β agent, resulted in a reduction in non-fatal myocardial infarction, non-fatal stroke, or death. This provided evidence for the inflammatory hypothesis of CAD. However, canakinumab is not cost-effective for widespread therapy and more cost-effective treatments are warranted. The Cardiovascular Inflammation Reduction Trial (CIRT), Colchicine Cardiovascular Outcomes Trial (COLCOT), and Low-Dose Colchicine 2 (LoDoCo2) are recent clinical trials that increased the understanding of the inflammatory hypothesis of CAD.

Summary

Cost-effective therapies targeting inflammation are the future of preventative CAD treatment. Additional clinical trials with anti-inflammatory and anti-cytokine agents would help delineate the most beneficial target for CAD prevention.

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Authors and Affiliations

  1. Department of Internal Medicine, George Washington University Hospital, Washington, DC, USA

    Julia Boland

  2. Department of Cardiology, University of California San Francisco, San Francisco, CA, USA

    Carlin Long

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Correspondence to Julia Boland.

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Boland, J., Long, C. Update on the Inflammatory Hypothesis of Coronary Artery Disease. Curr Cardiol Rep 23, 6 (2021). https://doi.org/10.1007/s11886-020-01439-2

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