CBS 2019
CBSMD教育中心
中 文

科学研究

Abstract

Recommended Article

Comparison of inhospital mortality, length of hospitalization, costs, and vascular complications of percutaneous coronary interventions guided by ultrasound versus angiography 3-Year Outcomes of the ULTIMATE Trial Comparing Intravascular Ultrasound Versus Angiography-Guided Drug-Eluting Stent Implantation Contribution of stent underexpansion to recurrence after sirolimus-eluting stent implantation for in-stent restenosis Successful bailout stenting strategy against lethal coronary dissection involving left main bifurcation Transcatheter Aortic Valve Replacement During Pregnancy Criteria for Iron Deficiency in Patients With Heart Failure Transcatheter Aortic Valve Replacement vs Surgical Replacement in Patients With Pure Aortic Insufficiency Genotyping to Guide Clopidogrel Treatment: An In-Depth Analysis of the TAILOR-PCI Trial

Review ArticleVolume 72, Issue 25, December 2018

JOURNAL:J Am Coll Cardiol. Article Link

Clinician’s Guide to Reducing Inflammation to Reduce Atherothrombotic Risk

PM Ridker Keywords: atherosclerosis; canakinumab; CANTOS; inflammation; interleukin-1

ABSTRACT


Life-threatening cardiovascular events occur despite control of conventional risk factors. Inflammation, as measured by high-sensitivity C-reactive protein (hsCRP) concentration, is associated with future vascular events in both primary and secondary prevention, independent of usual risk markers. Statins are powerful lipid-lowering agents with clinically relevant anti-inflammatory effects. Recent data support targeting the interleukin (IL)-1-to-IL-6-to-CRP signaling pathway as an adjunctive method for atheroprotection. The CANTOS (Canakinumab Anti-inflammatory Thrombosis Outcomes Study) trial showed that reducing inflammation through IL-1β inhibition significantly reduced vascular risk, beyond that achievable with lipid lowering. CANTOS further demonstrated a 31% reduction in cardiovascular mortality and all-cause mortality among patients treated with canakinumab who achieved the largest reductions in hsCRP, as well as efficacy in high-risk patients with chronic kidney disease and diabetes. This review outlines the clinical implications of CANTOS for patients with “residual inflammatory risk,” the potential benefits and risks associated with anti-inflammatory therapy, and the importance of CANTOS for future drug development.