{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:07:14Z","timestamp":1788826034997,"version":"build-2803163510"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"Supplement_E","license":[{"start":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T00:00:00Z","timestamp":1633910400000},"content-version":"vor","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Four large trials have recently evaluated the effects of anti-inflammatory drugs in the secondary prevention of major cardiovascular events (MACE) in over 25\u00a0000 patients followed for 1.9\u20133.7\u2009years. CANTOS tested subcutaneous canakinumab [an anti-interleukin (IL) 1\u03b2 antibody] 300\u2009mg every 3\u2009months against placebo in patients with a history of myocardial infarction (MI) and serum C-reactive protein (CRP) &amp;gt;2\u2009mg\/L, demonstrating efficacy in preventing MACE but increased rates of fatal infections. COLCOT (in patients with recent MI) and LoDoCo2 (in patients with chronic coronary syndromes) tested oral colchicine (an NLRP3 inflammasome inhibitor) 0.5\u2009mg daily vs. placebo, demonstrating prevention of MACE with a slightly increased risk of pneumonia in COLCOT (0.9 vs. 0.4%) but not in LoDoCo2. CIRT tested oral methotrexate (an anti-rheumatic anti-nuclear factor-kB) 15\u201320\u2009mg per week against placebo in ischaemic heart disease patients with diabetes or metabolic syndrome, without significant reduction in MACE rates or in circulating IL6 or CRP levels, and with increased risk of skin cancers. In summary, canakinumab and colchicine have shown efficacy in preventing MACE in ischaemic heart disease patients, but only colchicine has acceptable safety (and cost) for use in secondary cardiovascular prevention. Clinical results are expected with the anti-IL6 ziltivekimab.<\/jats:p>","DOI":"10.1093\/eurheartj\/suab084","type":"journal-article","created":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T07:49:56Z","timestamp":1633938596000},"page":"E13-E18","source":"Crossref","is-referenced-by-count":34,"title":["Anti-inflammatory therapy in ischaemic heart disease: from canakinumab to colchicine"],"prefix":"10.1093","volume":"23","author":[{"given":"Felicita","family":"Andreotti","sequence":"first","affiliation":[{"name":"Direzione Scientifica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy"},{"name":"Dipartimento di Scienze Cardiovascolari, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo Pietro","family":"Maggioni","sequence":"additional","affiliation":[{"name":"ANMCO Research Center, Fondazione per il Tuo cuore, Florence, Italy"},{"name":"GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Campeggi","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelaide","family":"Iervolino","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Scambia","sequence":"additional","affiliation":[{"name":"Direzione Scientifica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Massetti","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy"},{"name":"Dipartimento di Scienze Cardiovascolari, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,10,8]]},"reference":[{"key":"2021101106040206600_suab084-B1","first-page":"14","article-title":"Is it time to introduce anti-inflammatory drugs into secondary cardiovascular prevention: evidence from clinical trials?","volume":"5","author":"Maggioni","year":"2021","journal-title":"Vessel Plus"},{"key":"2021101106040206600_suab084-B2","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1161\/01.CIR.100.8.793","article-title":"Increased proinflammatory cytokines in patients with chronic stable angina and their reduction by aspirin","volume":"100","author":"Ikonomidis","year":"1999","journal-title":"Circulation"},{"key":"2021101106040206600_suab084-B3","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.bbi.2007.07.005","article-title":"Aspirin, but not propranolol, attenuates the acute stress-induced increase in circulating levels of interleukin-6: a randomized, double-blind, placebo-controlled study","volume":"22","author":"von K\u00e4nel","year":"2008","journal-title":"Brain Behav Immun"},{"key":"2021101106040206600_suab084-B4","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.1211\/jpp.61.11.0010","article-title":"Efficacy of different doses of aspirin in decreasing blood levels of inflammatory markers in patients with cardiovascular metabolic syndrome","volume":"61","author":"Gao","year":"2009","journal-title":"J Pharm Pharmacol"},{"key":"2021101106040206600_suab084-B5","doi-asserted-by":"crossref","first-page":"2739","DOI":"10.1161\/CIRCULATIONAHA.112.122556","article-title":"Effects of interleukin-1\u03b2 inhibition with canakinumab on hemoglobin A1c, lipids, C-reactive protein, interleukin-6, and fibrinogen: a phase IIb randomized, placebo-controlled trial","volume":"126","author":"Ridker","year":"2012","journal-title":"Circulation"},{"key":"2021101106040206600_suab084-B6","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1083\/jcb.67.1.237","article-title":"Inhibition by colchicine of fibrinogen translocation in hepatocytes","volume":"67","author":"Feldmann","year":"1975","journal-title":"J Cell Biol"},{"key":"2021101106040206600_suab084-B7","first-page":"343","article-title":"The effect of colchicine on the development of experimental atherosclerosis in rabbits","volume":"38","author":"W\u00f3jcicki","year":"1986","journal-title":"Pol J Pharmacol Pharm"},{"key":"2021101106040206600_suab084-B8","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1056\/NEJMoa1809798","article-title":"Low-dose methotrexate for the prevention of atherosclerotic events","volume":"380","author":"Ridker","year":"2019","journal-title":"N Engl J Med"},{"key":"2021101106040206600_suab084-B9","doi-asserted-by":"crossref","first-page":"2060","DOI":"10.1016\/S0140-6736(21)00520-1","article-title":". IL-6 inhibition with ziltivekimab in patients at high atherosclerotic risk (RESCUE): a double-blind, randomised, placebo-controlled, phase 2 trial","volume":"397","author":"Ridker","year":"2021","journal-title":"Lancet"},{"key":"2021101106040206600_suab084-B10","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1056\/NEJM199901143400207","article-title":"Atherosclerosis\u2014an inflammatory disease","volume":"340","author":"Ross","year":"1999","journal-title":"N Engl J Med"},{"key":"2021101106040206600_suab084-B11","doi-asserted-by":"crossref","first-page":"1821","DOI":"10.1093\/eurheartj\/ehp266","article-title":"The unstable plaque: a broken balance","volume":"30","author":"Crea","year":"2009","journal-title":"Eur Heart J"},{"key":"2021101106040206600_suab084-B12","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.thromres.2009.11.010","article-title":"Composition of thrombi in late drug-eluting stent thrombosis versus de novo acute myocardial infarction","volume":"126","author":"Nishihira","year":"2010","journal-title":"Thromb Res"},{"key":"2021101106040206600_suab084-B13","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1016\/0735-1097(90)90300-E","article-title":"Early coronary reperfusion blunts the procoagulant response of plasminogen activator inhibitor-1 and von Willebrand factor in acute myocardial infarction","volume":"16","author":"Andreotti","year":"1990","journal-title":"J Am Coll Cardiol"},{"key":"2021101106040206600_suab084-B14","first-page":"S3","volume-title":"Blood Coagul Fibrinolysis","author":"Andreotti","year":"1999"},{"key":"2021101106040206600_suab084-B15","doi-asserted-by":"crossref","first-page":"1668","DOI":"10.1161\/01.ATV.0000029781.31325.66","article-title":"Interrelationships among circulating interleukin-6, C-reactive protein, and traditional cardiovascular risk factors in women","volume":"22","author":"Bermudez","year":"2002","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"2021101106040206600_suab084-B16","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/S0140-6736(86)90111-X","article-title":"Haemostatic function and ischaemic heart disease: principal results of the Northwick Park Heart Study","volume":"2","author":"Meade","year":"1986","journal-title":"Lancet"},{"key":"2021101106040206600_suab084-B17","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1001\/jama.1987.03400090067035","article-title":"Fibrinogen and risk of cardiovascular disease. The Framingham Study","volume":"258","author":"Kannel","year":"1987","journal-title":"JAMA"},{"key":"2021101106040206600_suab084-B18","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1056\/NEJM199408183310701","article-title":"The prognostic value of C-reactive protein and serum amyloid a protein in severe unstable angina","volume":"331","author":"Liuzzo","year":"1994","journal-title":"N Engl J Med"},{"key":"2021101106040206600_suab084-B19","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.1093\/eurheartj\/ehi192","article-title":"Increased circulating C-reactive protein and macrophage-colony stimulating factor are complementary predictors of long-term outcome in patients with chronic coronary artery disease","volume":"26","author":"Ikonomidis","year":"2005","journal-title":"Eur Heart J"},{"key":"2021101106040206600_suab084-B20","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1056\/NEJMoa1707914","article-title":"Antiinflammatory therapy with canakinumab for atherosclerotic disease","volume":"377","author":"Ridker","year":"2017","journal-title":"N Engl J Med"},{"key":"2021101106040206600_suab084-B21","doi-asserted-by":"crossref","first-page":"2497","DOI":"10.1056\/NEJMoa1912388","article-title":"Efficacy and safety of low-dose colchicine after myocardial infarction","volume":"381","author":"Tardif","year":"2019","journal-title":"N Engl J Med"},{"key":"2021101106040206600_suab084-B22","doi-asserted-by":"crossref","first-page":"1838","DOI":"10.1056\/NEJMoa2021372","article-title":"Colchicine in patients with chronic coronary disease","volume":"383","author":"Nidorf","year":"2020","journal-title":"N Engl J Med"}],"container-title":["European Heart Journal Supplements"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/eurheartjsupp\/article-pdf\/23\/Supplement_E\/E13\/40544757\/suab084.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/eurheartjsupp\/article-pdf\/23\/Supplement_E\/E13\/40544757\/suab084.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T07:50:22Z","timestamp":1633938622000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurheartjsupp\/article\/23\/Supplement_E\/E13\/6386356"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,1]]},"references-count":22,"journal-issue":{"issue":"Supplement_E","published-online":{"date-parts":[[2021,10,8]]},"published-print":{"date-parts":[[2021,10,9]]}},"URL":"https:\/\/doi.org\/10.1093\/eurheartj\/suab084","relation":{},"ISSN":["1520-765X","1554-2815"],"issn-type":[{"value":"1520-765X","type":"print"},{"value":"1554-2815","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,10,1]]},"published":{"date-parts":[[2021,10,1]]}}}