Anti-Inflammatory Therapy Linked to Reduction of CV Events

Stephanie Edwards for Medscape

November 15, 2021

This is a summary of a preprint research study by Zhi-Lu Wang and colleagues from The First Hospital of Lanzhou University on Research Square, provided to you by Medscape. This study has not yet been peer-reviewed. The full text of the study can be found on

Key Takeaway

  • Patients with coronary artery disease (CAD) who received anti-inflammatory therapy had significantly lower incidence of cardiovascular death, myocardial infarction (MI), and stroke than patients not receiving anti-inflammatory therapy, results of a systematic review and meta-analysis of randomized trials suggest.  

Why This Matters

  • Chronic inflammation and its association with the development of atherosclerosis and CAD has been hypothesized for many years; however, the efficacy of anti-inflammatory therapy has remained controversial and is not currently recommended by the guidelines in patients with CAD.

Study Design

  • Researchers used data from randomized controlled trials including 61,164 patients with CAD (32,227 patients receiving anti-inflammatory therapy and 28,937 not receiving anti-inflammatory therapy).

  • Anti-inflammatory therapies included colchicine, PLA2 inhibitors such as varespladib and darapladib, as well as canakinumab and methotrexate.

  • The primary outcome was a composite of cardiovascular death, MI, and stroke. Secondary outcomes included MI, coronary revascularization, cardiovascular death, all-cause death, and stroke.

Key Results

  • The primary outcome was significantly lower in patients receiving anti-inflammatory therapy than those who did not (10.66% vs 10.86%; relative risk [RR] 0.93; 95% CI, 0.89 - 0.98; P = .006).

  • Anti-inflammatory therapy was associated with a significantly reduced risk of MI compared with patients not receiving anti-inflammatory therapy (5.66% vs 6.03%; RR, 0.90; 95% CI, 0.84 - 0.96; P = .002).

  • Coronary revascularization was significantly lower in patients taking anti-inflammatory therapy (1.94% vs 2.66%; RR, 0.74; 95% CI, 0.66 - 0.84; P < .00001).

  • There was no statistical difference in the risk of cardiovascular death, all-cause death, and stroke between groups.

  • Anti-inflammatory drugs targeting the central interleukin-6 inflammatory signaling pathway such as colchicine and canakinumab reduced the risk of primary outcome but anti-inflammatory therapy using PLA2 inhibitors showed no statistically significant effect.  


  • Participants in this trial included patients with acute coronary syndrome and chronic coronary syndrome, potentially causing heterogeneity.

  • The three small-sample-size trials had a low incidence of positive events and a wide confidence interval, reducing the quality of evidence.

  • Low follow-up rate of three trials reduces the reliability of results.

Study Disclosures

  • No disclosures

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