CBS 2019
CBSMD教育中心
English

科学研究

科研文章

荐读文献

Efficacy and Safety of Dapagliflozin in Heart Failure With Reduced Ejection Fraction According to Age: Insights From DAPA-HF Feasibility of Coronary Access and Aortic Valve Reintervention in Low-Risk TAVR Patients Optical Frequency Domain Imaging Versus Intravascular Ultrasound in Percutaneous Coronary Intervention (OPINION Trial) Results From the OPINION Imaging Study Clinical trial design and rationale of the Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3 (MOMENTUM 3) investigational device exemption clinical study protocol The year in cardiovascular medicine 2020: heart failure and cardiomyopathies Impact of plaque components on no-reflow phenomenon after stent deployment in patients with acute coronary syndrome: a virtual histology-intravascular ultrasound analysis Atrial Fibrillation and the Prognostic Performance of Biomarkers in Heart Failure A three-vessel virtual histology intravascular ultrasound analysis of frequency and distribution of thin-cap fibroatheromas in patients with acute coronary syndrome or stable angina pectoris H2FPEF Score for Predicting Future Heart Failure in Stable Outpatients With Cardiovascular Risk Factors Fractional flow reserve derived from CCTA may have a prognostic role in myocardial bridging

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.