Looking beyond lipids, is there swelling evidence?

By James Joseph Rybacki, Pharm.D. 1/8/19

Even when patients are treated to blood pressure and cholesterol goals, they still have heart attacks and some of them die. This sobering fact has led to an emerging residual cardiovascular risk, residual inflammatory burden and a number of other explanations.

The CANTOS or the Canakinumab Anti-Inflammatory Thrombosis Outcomes Study took a look at the idea that inflammation had a role in cardiac events. The results did indeed show that 150 mg of canakinumab worked better than a sugar pill at preventing bad (adverse) heart (cardiac) events.

You may not have heard about canakinumab unless you’ve been ready nerdy research or have recently attended a heart meeting. This experimental medicine is a MAB (monoclonal antibody) that works against an inflammatory molecoule called interleukin-Beta. The goal of CANTOS was to see how placebo stacked up against canakinumab in people with a history of heart attack (MI) and an elevated high sensitivity C-reactive protein levels (HsCRP).

It appears that the evidence is growing (swelling) for some kind of role of inflammation, but the exact cause of the swelling and the ideal way to lower the swelling and heart attack risk have yet to be clearly decided.