Interplay between hypercholesterolaemia and inflammation in atherosclerosis: Translating experimental targets into clinical practice

European Journal of Preventive Cardiology
José TuñónESC Working Group on Atherosclerosis and Vascular Biology

Abstract

Dyslipidaemia and inflammation are closely interconnected in their contribution to atherosclerosis. In fact, low-density lipoprotein (LDL)-lowering drugs have anti-inflammatory effects. The Canakinumab Antiinflammatory Thrombosis Outcome Study (CANTOS) has shown that interleukin (IL)-1β blockade reduces the incidence of cardiovascular events in patients with previous myocardial infarction and C-reactive protein levels >2 mg/L. These data confirm the connection between lipids and inflammation, as lipids activate the Nod-like receptor protein 3 inflammasome that leads to IL-1β activation. LDL-lowering drugs are the foundation of cardiovascular prevention. Now, the CANTOS trial demonstrates that combining them with IL-1β blockade further decreases the incidence of cardiovascular events. However, both therapies are not at the same level, given the large evidence showing that LDL-lowering drugs reduce cardiovascular risk as opposed to only one randomized trial of IL-1β blockade. In addition, IL-1β blockade has only been studied in patients with C-reactive protein >2 mg/L, while the benefit of LDL-lowering is not restricted to these patients. Also, lipid-lowering drugs are not harmful even at very low ranges of LDL, while anti-inflam...Continue Reading

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Citations

May 16, 2018·European Journal of Preventive Cardiology·Viviane Z Rocha, Raul D Santos
May 8, 2019·European Journal of Preventive Cardiology·Cesare R SirtoriMassimiliano Ruscica
May 30, 2019·Journal of the American Heart Association·Juan Jesus CarreroTomas Jernberg
Jul 18, 2019·Journal of Food Science·Rongrong LuZhuoqin Jiang
Dec 29, 2019·European Journal of Heart Failure·Markus S AnkerStefan D Anker
Aug 15, 2020·Journal of Internal Medicine·R BaumgartnerD F J Ketelhuth
Jun 4, 2019·European Journal of Preventive Cardiology·Massimo F Piepoli
Aug 21, 2020·Bioscience Reports·Daniela PirriPaul C Evans
Nov 28, 2018·European Journal of Preventive Cardiology·Chiara MacchiMassimiliano Ruscica
Jan 10, 2020·European Journal of Preventive Cardiology·Massimo F Piepoli
Feb 1, 2019·Circulation Research·Robert S RosensonWolfgang Koenig
Mar 1, 2019·European Journal of Preventive Cardiology·Mario Gaudino, Filippo Crea
Dec 29, 2020·Frontiers in Immunology·Wuqian Mai, Yuhua Liao
Jul 3, 2021·Journal of Clinical Medicine·Ana María Pello LázaroJosé Tuñón
Jul 24, 2021·Expert Review of Hematology·Osama Ahmad IbrahimWalaa H Mohammad Ibrahim

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Clinical Trials Mentioned

NCT02551094

Software Mentioned

CANTOS

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