One of the first-line treatments for patients with heart disease are cholesterol-lowering medications known as statins, which have been shown for years to reduce mortality in patients with heart disease or those who are at risk for heart disease. When cholesterol is elevated in the blood, it accumulates on and damages the arterial walls which cause the arteries to become more narrow and restricts blood flow. The damage to the arteries results in an inflammatory response and leads to platelet formation at the injured site, further narrowing the arteries, a process known as atherosclerosis.
A study sponsored by Novartis sought to determine if preventing inflammation independent of lowering cholesterol can reduce the risk of recurrent strokes or heart attacks, testing what is known as the Inflammatory Hypothesis. They tested the effects of canakinumab, a protein with anti-inflammatory effects (canakinumab is a monoclonal antibody against interleukin-1ß, which causes inflammation). The study involved 10,061 patients who have previously had a heart attack or stroke, have elevated hs-CRP (high sensitivity C-reactive protein — an indicator of inflammation; increased levels are associated with risk of heart attacks or strokes), and being currently treated for heart disease. Patients were randomly assigned to receive three various doses of canakinumab or placebo.
Results from this study showed that patients treated with 150mg of canakinumab had significantly lower incidence of recurrent heart attacks and strokes than the patients treated with placebo. Canakinumab also significantly reduced hs-CRP levels compared to placebo.
By reducing the incidence of cardiovascular events without lowering cholesterol, this study shows that anti-inflammatory therapy may be beneficial in reducing cardiovascular risk.
Reference to the study: http://www.nejm.org/doi/full/10.1056/NEJMoa1707914?query=featured_home