Inflammation revisited: Atherosclerosis in the post-CANTOS era

Abstract

It is fairly well accepted in the scientific community that atherosclerosis carries features of a local and low-grade systemic inflammation. However, it was unclear thus far whether this is simply an epiphenomenon or if it plays a causal role in atherosclerosis and its clinical complications. After several failed attempts, the Canakinumab Anti-inflammatory Thrombosis Outcomes Study (CANTOS) has provided convincing evidence of interleukin-1 beta as a target whose neutralisation by a selective antibody reduces major cardiovascular events without affecting LDL-cholesterol. This provides strong evidence in support of the inflammation hypothesis and will certainly stimulate research in this area and open the way for novel therapy in high-risk patients following MI.