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

Thomas F. Lüscher


Eur Heart J. 2020;41(42):4100-4102. 

In This Article

Inflammation and Acute Coronary Syndromes

A patient population in which inflammation is particularly important are those with ACS. Indeed, at the time of such an acute event, CRP and SAA plasma levels are several magnitudes higher than in patients with chronic coronary syndromes.[10] Thus, it seems that ACS are associated with an inflammatory burst. Of note, inflammation is particularly high at the site of acute coronary occlusion, with an array of cytokines expressed, among them interleukins[10] acting on Toll-like receptors on white blood cells in a vicious cycle leading to an acute inflammatory storm.[14] In this context, inflammation is a major trigger of plaque vulnerability, erosion, or rupture, and eventually coronary occlusion. After reperfusion, as occurs after successful primary percutaneous coronary intervention, inflammation importantly contributes to reperfusion injury also in the myocardium[15] and in turn increases infarct size and scar formation, leading to left ventricular remodelling[16] and MACE.