Anti-Inflammatory Therapy Linked to Reduction of CV Events
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 This study has not yet been peer-reviewed.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
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