Inflammation in Ischemic Heart Disease: Pathophysiology, Biomarkers, and Therapeutic Implications

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About this Research Topic

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Background

Inflammation is the main pathophysiological process involved in atherosclerotic plaque formation, progression, instability, and healing. C reactive protein, a well-known marker of inflammation, has proved to be an important predictor of cardiovascular events in patients with coronary syndromes. For decades, a relentless search has been performed to find the most effective strategy to control and/or inhibit inflammatory pathways. In the CANTOS trial the robustness of the inflammatory hypothesis of atherosclerosis was further proved, showing that canakinumab, a fully human monoclonal antibody targeting proinflammatory interleukin-1β, causes a significant reduction in major adverse cardiovascular events in patients with stable coronary artery disease.

Various antinflammatory drugs were tested in the setting of cardiovascular (CV) disease, including methotrexate and immunosuppressors in general, monoclonal antibody, and small molecules. However, a net clinical benefit in terms of cardiovascular outcomes was often not achieved and, moreover, concerns about the risk of increased incidence of infections limited the enthusiasm towards these treatments.

More recently, the idea of using colchicine, an old and well-known antinflammatory drug, stimulated new research efforts in treatment and prevention of coronary artery disease, with interesting, despite not always concordant results. A complete understanding of the pathophysiological mechanisms that link inflammation, immunity, atherosclerotic plaque formation and ischemic heart disease has not yet been reached. This represents a topic of great interest in the present cardiology research field.

Led by an international team of subject experts, this research topic will provide new evidence and summarize established knowledge regarding pathophysiology, biomarkers, and therapeutic implications of inflammation pathways and ischemic heart disease, with a special focus on novel emerging therapies. Papers highlighting the clinical benefits in terms of cardiovascular outcomes will be particularly appreciated as well as papers regarding complications related to the use of antinflammatory and immunomodulatory drugs. All manuscript types will be accepted with a particular focus on original work, systematic reviews and meta-analysis, narrative reviews, case series and educational case reports.

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Keywords: ischemic heart disease, inflammation, biomarkers, pathophysiology

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