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Targeting Inflammation After Myocardial Infarction

  • Management of Acute Coronary Syndromes (H Jneid, Section Editor)
  • Published:
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Abstract

Purpose of Review

Inflammation plays a key role in clearing cellular debris and recovery after acute myocardial infarction (AMI). Dysregulation of or prolonged inflammation may result in adverse cardiac remodeling and major adverse clinical events (MACE). Several pre-clinical studies and moderate sized clinical trials have investigated the role of immunomodulation in improving clinical outcomes in patients with AMI.

Recent Findings

Clinical data from the Canakinumab Atherothrombosis Outcome (CANTOS) and Colchicine Cardiovascular Outcomes Trial (COLCOT) have provided encouraging results among patients with AMI. Several other clinical and pre-clinical trials have brought about the prospect of modulating inflammation at various junctures of the inflammatory cascade including inhibition of complement cascade, interleukins, and matrix metalloproteinases.

Summary

In patients with AMI, modulation of residual inflammation via various inflammatory pathways and mediators may hold promise for further reducing MACE. Learning from current data and understanding the nuances of immunomodulation in AMI are key for future trials and before widespread dissemination of such therapies.

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Authors and Affiliations

  1. Health Policy, Quality & Informatics Program,, Michael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX, USA

    Dhruv Mahtta & Salim S. Virani

  2. Division of Cardiovascular Medicine, Baylor College of Medicine, Houston, TX, USA

    Dhruv Mahtta, Deepthi Sudhakar, Salim S. Virani & Hani Jneid

  3. Division of Cardiovascular Medicine,, Texas Heart Institute and Baylor College of Medicine, Houston, TX, USA

    Srikanth Koneru, Guilherme Vianna Silva & Mahboob Alam

  4. Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, 77030, USA

    Salim S. Virani & Hani Jneid

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All authors contributed to the article conception. Dhruv Mahtta provided the first draft of the manuscript. Hani Jneid critically revised the work. All authors read and approved the final manuscript.

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Correspondence to Hani Jneid.

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Guilherme Vianna Silva reports other from Medtronic and Abbott. Salim S. Virani reports grants from Department of Veterans Affairs, World Heart Federation, and Tahir and Jooma Family; Honorarium from the American College of Cardiology (Associate Editor for Innovations, acc.org); and other as a Steering Committee Member (Patient and Provider Assessment of Lipid Management (PALM) registry at Duke Clinical Research Institute [no financial remuneration]).

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Mahtta, D., Sudhakar, D., Koneru, S. et al. Targeting Inflammation After Myocardial Infarction. Curr Cardiol Rep 22, 110 (2020). https://doi.org/10.1007/s11886-020-01358-2

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