On Demand: Targeting Cardiac Inflammation as an Approach to CV Risk Reduction-Presentation Slides

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The document discusses the strategic approach to reducing cardiovascular (CV) risk by targeting cardiac inflammation. It is emphasized by John G. Canto, MD, highlighting various research, patient cases, and recent developments in pharmacological therapies.<br /><br />**Key Points:**<br /><br />1. **FDA Approval of LODOCO**: The U.S. FDA has approved LODOCO, the first anti-inflammatory drug for cardiovascular risk reduction, effective June 20, 2023. It is indicated for reducing risks of myocardial infarction (MI), stroke, coronary revascularization, and cardiovascular death in patients with established atherosclerotic disease or multiple risk factors.<br /><br />2. **Prevalence and Risk Factors**: The document reports the prevalence of individual risk factors like hypertension, family history, diabetes, cholesterol, and smoking at the time of MI presentation from a national registry (1994-2006). Key data points indicate significant portions of the population present with these risk factors.<br /><br />3. **Lifestyle and Genetic Factors**: Lifestyle and genetic factors contribute significantly to MI risk. Factors like exercise, weight management, nutrition, blood sugar, blood pressure, smoking, sleep, and stress are critical for managing risk.<br /><br />4. **Inflammation and Cardiovascular Disease**: Chronic inflammation is associated with obesity, diabetes, hypertension, and poor lifestyle habits. There's strong biological plausibility and clinical evidence supporting that targeting inflammation can reduce CV events independently of traditional risk factors like LDL cholesterol or blood pressure.<br /><br />5. **Efficacy of Low-Dose Colchicine**: The document highlights that low-dose colchicine (0.5 mg) has proven effective in reducing the risk of heart attacks, strokes, stents, and CV death up to 31%. It also notes that colchicine has a narrow therapeutic window, requiring careful dosing, particularly in patients with impaired renal or hepatic function.<br /><br />6. **CV Prevention Dual Pathways**: Treating residual inflammatory risk in patients on maximized tolerated statin therapy is discussed. Stratified pathways suggest additional cholesterol or inflammation-lowering agents based on LDL-C and hsCRP levels.<br /><br />7. **Conclusion**: Inflammation is a significant predictor of future CV events, and the use of low-dose colchicine is a validated, safe option for select patients. However, it is unsuitable for those with severe renal or hepatic impairment. Statins remain a cornerstone of CV risk reduction therapy.<br /><br />The document reflects ongoing updates and current practices in managing cardiovascular disease by integrating inflammation-targeting treatments alongside traditional approaches.
Keywords
cardiovascular risk
cardiac inflammation
LODOCO approval
myocardial infarction
risk factors
lifestyle factors
chronic inflammation
low-dose colchicine
CV prevention
statin therapy