Long-Term Cardiovascular Outcomes OF Anti-Inflammatory Therapies IN Atherosclerotic Cardiovascular Disease: A Systematic Review AND Meta-Analysis

Abstract

Background
Atherosclerotic cardiovascular disease (ASCVD) is yet another big reason of morbidity and mortality in the world. Inflammation has a prominent role in the aetiopathogenesis and advancement of atherosclerosis. Recent studies have examined the possibility of using anti-inflammatory therapies for adjunctive treatment in improving cardiovascular outcomes in patients with ASCVD.
Objectives
To perform a systematic review and meta-analysis of the long-term cardiovascular consequences of anti-inflammatory treatment in individuals with established ASCVD, focusing on MACE (major adverse cardiovascular events), hospitalization rates, and all-cause mortality
Methodology
A detailed search for randomized controlled trials (RCTs) and observational studies of a sufficient standard published between 2004 and 2024 was performed in the PubMed, Embase, and Cochrane Library data bases. Studies evaluating anti-inflammatory therapies such as canakinumab, colchicine, and other agents targeting inflammatory pathways administered to ASCVD patients were included. For each study, details were extracted concerning study design, characteristics of the population, intervention, and clinical outcomes. Data were pooled for effect estimate using the random-effects model.
Results
Eighteen studies comprising over 65,000 patients were included. Anti-inflammatory therapies, particularly canakinumab and colchicine, were associated with a significant reduction in MACE (RR: 0.84; 95% CI: 0.77–0.91; p < 0.001) compared to standard therapy alone. Canakinumab demonstrated a notable reduction in recurrent myocardial infarction and cardiovascular mortality, while colchicine was effective in lowering hospitalization rates for cardiovascular causes. However, heterogeneity was observed across trials, and some therapies were associated with a higher risk of non-cardiovascular adverse events.
Conclusion
There is a positive outlook that anti-inflammatory therapies may be beneficial in reducing adverse cardiovascular outcomes in patients with ASCVD. While agents such as canakinumab and colchicine reduce the risk of major adverse cardiovascular events (MACE), each safety profile must be considered. There is a need for further long-term studies to optimize patient selection and properly elucidate the wider implications for targeting inflammation in cardiovascular care.