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 This study has not yet been peer-reviewed.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 Researchsquare.com.

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.  

Limitations

  • 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

For more from theheart.org | Medscape Cardiology, join us on Twitter and Facebook

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.

processing....

Recommendations