Inflammation as a Modifiable Driver of Ischemic Heart Disease: Mechanisms, Clinical Risks, and Evolving Therapeutic Options

This review highlights the significant role of inflammation in ischemic heart disease (IHD), especially after acute myocardial infarction (AMI), and its potential as a therapeutic target. Inflammation has been linked to cardiovascular events, with biomarkers like C-reactive protein (CRP) being important for prognosis. Clinical trials such as CANTOS and COLCOT demonstrate that anti-inflammatory therapies can reduce major adverse cardiac events (MACE) independently of lipid-lowering treatments. The review discusses the mechanisms of inflammation in atherosclerosis, the complexity of inflammatory pathways, and the efficacy and safety of treatments like low-dose aspirin, statins, canakinumab, colchicine, and new agents like Ziltivekimab. It emphasizes the need for personalized treatment, particularly for elderly patients, and advocates for recognizing inflammation as a key target in cardiovascular care.