The Sooner, the Better: Anti-inflammation in Acutemyocardial Infarction

Thomas F. Lüscher


Eur Heart J. 2020;41(42):4100-4102. 

In This Article

Virchow's Prophecy

The late Rudolf L.C. Virchow (1821–1902) made a visionary statement when he wrote in one of his textbooks 'Atherosclerosis is a chronic inflammation induced by cholesterol'.[1] It did not have much impact for several decades until the Russian scientist Nikolay Nikolaevich Anichkov (1885–1964) showed in his seminal experiments in the rabbit aorta that a high fat diet induces cholesterol-rich plaques.[2] Thereafter, research focused on cholesterol rather than inflammation, with crucial epidemiological studies in Framingham and worldwide confirming an association of plasma lipid levels with the complications of atherosclerosis, i.e. myocardial infarction, stroke, and sudden and premature death.[3] The final proof of the cholesterol hypothesis came with the 4S trial using simvastatin in patients with coronary artery disease, demonstrating an impressive reduction of major cardiovascular events with pharmacological cholesterol lowering.[4]