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 the development of ischemic heart disease (IHD), especially after acute myocardial infarction (AMI). It discusses how inflammation has been linked to cardiovascular events since the mid-20th century, with biomarkers like C-reactive protein (CRP) being important for prognosis. Clinical trials such as CANTOS and COLCOT demonstrate that targeting inflammation can reduce major adverse cardiac events (MACE) independently of traditional lipid-lowering treatments. The review examines the mechanisms of inflammation in atherosclerosis and the interaction with risk factors, emphasizing the complexity of inflammatory pathways. It also evaluates both established and new pharmacological interventions, including low-dose aspirin, statins, canakinumab, colchicine, and emerging agents like Ziltivekimab, focusing on their efficacy and safety. The article advocates for personalized treatment approaches, particularly for elderly patients, and calls for recognizing inflammation as a key therapeutic target in cardiovascular care.