Inflammation in atherosclerotic cardiovascular disease: From diagnosis to treatment

European Journal of Clinical Investigation, Год журнала: 2025, Номер unknown

Опубликована: Март 8, 2025

Targeting inflammation offers a unique possibility to address residual cardiovascular risk in almost two thirds of all patients with prevalent atherosclerotic disease (ASCVD). However, despite FDA approval and the ESC 2024 Guidelines for Management Chronic Coronary Syndrome recommendations implement low-dose colchicine (0.5 mg daily) secondary prevention ASCVD inflammatory risk, its clinical adoption is still limited. In this regard, simple screening elevated high-sensitive C-reactive protein (hsCRP) on routine basis might help recognize low-grade as an important therapeutic target. Within present review, we first provide recently published epidemiologic evidence that hsCRP at least strong predictor future events traditional lipoproteins. Furthermore, summarize our recent knowledge currently available strategies modulate process critically discuss open issues regarding benefit therapy acute coronary setting or stroke prevention. addition, also briefly touch upon some specific safety related long-term use colchicine. Finally, next diagnostic frontiers targeting such detection vascular/coronary by pericoronary fat attenuation ziltivekimab, human monoclonal antibody interleukin-6. Thus, integration interventions aimed lowering burden combination aggressive lipid-modifying may hold potential further reduce substantial ASCVD.

Язык: Английский

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Hypercholesterolemia and inflammation—Cooperative cardiovascular risk factors

European Journal of Clinical Investigation, Год журнала: 2024, Номер unknown

Опубликована: Окт. 6, 2024

Abstract Background Maintaining low concentrations of plasma low‐density lipoprotein cholesterol (LDLc) over time decreases the number LDL particles trapped within artery wall, slows progression atherosclerosis and delays age at which mature atherosclerotic plaques develop. This substantially reduces lifetime risk cardiovascular disease (ASCVD) events. In this context, plaque development vulnerability result not only from lipid accumulation but also inflammation. Results Changes in composition immune cells, including macrophages, dendritic T B mast cells neutrophils, along with altered cytokine chemokine release, disrupt equilibrium between inflammation anti‐inflammatory mechanisms sites. Considering that it is a competition LDLc inflammation, instead they are partners crime, present narrative review aims to give an overview main inflammatory molecular pathways linked raised describe impact lipid‐lowering approaches on burden. Although remarkable changes driven by most recent lowering combinations, relative reduction C‐reactive protein appears be independent magnitude lowering. Conclusion Identifying clinical biomarkers (e.g. interleukin‐6) possible targets for therapy holds promise monitoring reducing ASCVD burden suitable patients.

Язык: Английский

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Interleukin-1 Blockers: A Paradigm Shift in the Treatment of Recurrent Pericarditis

Life, Год журнала: 2024, Номер 14(3), С. 305 - 305

Опубликована: Фев. 26, 2024

Recurrent pericarditis is a problematic clinical condition that impairs the quality of life affected patients due to need for repeated hospital admissions, emergency department visits, and complications from medications, especially glucocorticoids. Unfortunately, available treatments recurrent are very limited, including only handful medications such as aspirin/NSAIDs, glucocorticoids, colchicine, immunosuppressants (such interleukin-1 (IL-1) blockers, azathioprine, intravenous human immunoglobulins). Until recently, experience with latter class was limited. Nevertheless, in last decade, IL-1 blockers has consistently grown, valid data have emerged randomized trials. Accordingly, typical paradigm shift treatment refractory clearly positive cost/benefit ratio those unfortunate multiple recurrences. A drawback related above-mentioned absence universally accepted established protocols regarding full dose administration period tapering protocol individual medications. Another concern long-standing treatments, which should be discussed patients. The unmet needs expected addressed near future, further insights into pathophysiology an individualized approach

Язык: Английский

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Novel Therapeutics and Upcoming Clinical Trials Targeting Inflammation in Cardiovascular Diseases

Arteriosclerosis Thrombosis and Vascular Biology, Год журнала: 2024, Номер 44(12), С. 2371 - 2395

Опубликована: Окт. 10, 2024

Cardiovascular disease (CVD) remains a major health burden despite significant therapeutic advances accomplished over the last decades. It is widely and increasingly recognized that systemic inflammation not only represents cardiovascular risk prognostic factor but also plays key pathogenic roles in CVD development progression. Despite compelling preclinical evidence suggesting large potential of anti-inflammatory pharmacological interventions across numerous CVDs, clinical translation incomplete, mainly due to (1) yet undefined molecular signaling; (2) challenges safety efficacy profile drugs; (3) difficulties identifying optimal patient candidates responders therapeutics, as well windows. Randomized controlled trials demonstrated safety/efficacy canakinumab colchicine secondary prevention, providing confirmation for involvement specific inflammatory pathway (NLRP3 [NACHT, LRR, PYD domain-containing protein 3] inflammasome/IL [interleukin]-1β) atherosclerotic CVD. Colchicine was recently approved by US Food Drug Administration this indication. Diverse drugs targeting distinct pathways are used management other CVDs including myocarditis pericarditis. Ongoing research efforts directed implementing strategies growing number through repurposing available novel compounds, which herein concisely discussed. This review summarizes main characteristics findings completed upcoming randomized directly discusses future perspectives exciting constantly expanding landscape cardioimmunology.

Язык: Английский

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Prognostic Value of Inflammatory Cytokines in Predicting Hospital Readmissions in Heart Failure with Preserved Ejection Fraction

Journal of Inflammation Research, Год журнала: 2024, Номер Volume 17, С. 3003 - 3012

Опубликована: Май 1, 2024

The aim of this study was to explore the relationship between inflammatory cytokines and risk heart failure (HF) readmission in patients with preserved ejection fraction (HFpEF).

Язык: Английский

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Current understanding and management of cardiovascular involvement in rheumatic immune-mediated inflammatory diseases

Nature Reviews Rheumatology, Год журнала: 2024, Номер 20(10), С. 614 - 634

Опубликована: Сен. 2, 2024

Язык: Английский

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Air pollution and coronary atherosclerosis

Future Cardiology, Год журнала: 2025, Номер unknown, С. 1 - 14

Опубликована: Янв. 9, 2025

The recently introduced concept of 'exposome' emphasizes the impact non-traditional threats onto cardiovascular health. Among these, air pollutants – particularly fine particulate matter < 2.5 μm (PM2.5) have emerged as significant environmental risk factors for disease and mortality. PM2.5 exposure has been shown to induce endothelial dysfunction, chronic low-grade inflammation, cardiometabolic impairment, contributing development destabilization atherosclerotic plaques. Both short- long-term pollution considerably increase incidence ischemic heart (IHD)-related events, with clinical evidence linking higher mortality adverse prognosis, especially in vulnerable populations. In this review, we explore mechanistic pathways through which exacerbate (ASCVD) discuss their impact.

Язык: Английский

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Current Drug Treatment for Acute and Recurrent Pericarditis

Drugs, Год журнала: 2025, Номер unknown

Опубликована: Март 22, 2025

Pericarditis is the most frequent pericardial disease and presents with a relatively benign course when treated according to guideline-directed therapies at first presentation. Recurrence complication may occur more frequently after episode, in patients autoimmune etiology, who received glucocorticoids, or rapid (i.e., within 1 month) tapering of anti-inflammatory drugs. The therapeutic armamentarium for pericarditis includes high-dose nonsteroidal drugs (NSAIDs) that are tapered rapidly once symptoms controlled. Colchicine necessary both relieve reduce rate recurrences continued least 3-6 months. Low- moderate-dose glucocorticoids reserved recurrence which NSAIDs colchicine failed and/or have an disorder, slow tapering. Interleukin-1 blockers-anakinra, rilonacept, goflikicept-are used as third-line option cannot come off second-line therapy contraindications those high-risk features multiple episodes, markedly elevated inflammatory markers, extensive abnormalities imaging) whom treatment unlikely succeed.

Язык: Английский

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Peritoneal involvement in acute pericarditis with polyserositis may mimic acute cholecystitis: a case report

Italian Journal of Medicine, Год журнала: 2025, Номер unknown

Опубликована: Март 31, 2025

Acute pericarditis is an inflammatory disease of the pericardium that can exclusively affect or extend and other serosae, including pleura peritoneum. The involvement dysregulation inflammasome, a protein complex responsible for innate immune response, appear to be central in these forms idiopathic pericarditis. This multi-district interest leads considering recurrent also as possible systemic disease. Here, we report case 56-year-old male with negative past medical history who presented dyspnea, chest abdominal pain, low-grade fever. Routine investigations echocardiography were consistent acute pericarditis; X-ray revealed pleural effusion ultrasound detected modest peritoneal cholecystitis. symptoms completely regressed within 24 hours initiating therapy non-steroidal anti-inflammatory drugs colchicine. pericardial, pleural, effusions, along cholecystitis, next 4 weeks. first reported which polyserositis involved gallbladder process. It appears standard was effective inducing remission extracardiac processes, further supporting hypothesis autoinflammatory etiology cholecystic process well. Early identification implies shorter hospitalization times improved therapeutic classification patient, thereby reducing likelihood corticosteroid-dependent significantly lowering risk relapse.

Язык: Английский

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Cancer and cardiovascular diseases: A deadly combination

European Journal of Clinical Investigation, Год журнала: 2025, Номер unknown

Опубликована: Апрель 24, 2025

Язык: Английский

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