Recent Advances in Targeted Management of Inflammation In Atherosclerosis: A Narrative Review

Abstract

Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of morbidity and mortality despite effective low-density lipoprotein cholesterol-targeted therapies. This review explores the crucial role of inflammation in the residual risk of ASCVD, emphasizing its impact on atherosclerosis progression and plaque stability. Evidence suggests that high-sensitivity C-reactive protein (hsCRP), and potentially other inflammatory biomarkers, can be used to identify the inflammatory residual ASCVD risk phenotype and may serve as future targets for the development of more efficacious therapeutic approaches. We review the biological basis for the association of inflammation with ASCVD, propose new therapeutic strategies for the use of inflammation-targeted treatments, and discuss current challenges in the implementation of this new treatment paradigm for ASCVD.

Keywords: Atherosclerosis; Atherosclerotic cardiovascular disease; Canakinumab; Colchicine; Inflammation; Interleukins; LDL-C; NLRP3 inflammasome; Triglyceride-rich lipoproteins; Ziltivekimab.