Immune and Inflammation in Acute Coronary Syndrome: Molecular Mechanisms and Therapeutic Implications

Table 1

Major published and ongoing clinical studies targeting inflammation therapies in coronary artery disease.

Study	Subjects	Inflammatory target	Therapeutic agent	Median follow-up duration	Primary outcome	Benefit achieved
LoDoCo	Patients with stable CAD	Broad spectrum	Colchicine	3 years	Cardiac arrest, ACS, stroke	Yes [72]
CANTOS	Post-ACS patients with high level of hsCRP	IL-1β	Canakinumab	48 months	Cardiovascular death, nonfatal myocardial infarction or stroke	Yes [6]
CIRT	Type 2 diabetes or metabolic syndrome patients with recent ACS	Broad spectrum	Methotrexate	2.3 years	Cardiovascular death, nonfatal myocardial infarction or stroke, hospitalization for emergency revascularization	No [68]
COLCOT	Post-ACS patients	Broad spectrum	Colchicine	22.6 months	Cardiovascular death, resuscitated cardiac arrest, myocardial infarction, stroke, hospitalization for emergency revascularization	Yes [73]
CLEAR-SYNERGY	ACS patients with STEMI/SYNERGY stent	Broad spectrum	Colchicine and spironolactone	2 years	Cardiovascular death, stroke, recurrent myocardial infarction	Ongoing [75]
LoDoCo2	Patients with stable CAD	Broad spectrum	Colchicine	3 years	Cardiovascular death, ACS, stroke	Ongoing [75]
ASSAIL-MI	Patients with first STEMI	IL-6	Tocilizumab	6 months	Myocardial salvage index assessed by CMR 1 week after administration	Ongoing [70]
LATITUDE-TIMI 60	Patients with ACS	Mitogen-activated protein kinase	Losmapimod	12 weeks	Cardiovascular death, myocardial infarction, recurrent angina requiring emergency revascularization	No [80]
VCU-ART3	Patients with ACS	IL-1Ra	Anakinra	12 months	14-day changes in CRP levels, new-onset heart failure, long-term improvement of left ventricular ejection fraction	Ongoing [83]

Footnote. ACS: acute coronary syndrome; CRP: C-reactive protein; CMR: cardiovascular magnetic resonance; LoDoCo: Low-Dose Colchicine; CANTOS: Canakinumab. Anti-Inflammatory Thrombosis Outcome Study; CIRT: Cardiovascular Inflammation Reduction Trial; COLCOT: Colchicine Cardiovascular Outcomes Trial; CLEAR-SYNERGY: Colchicine and Spironolactone in Patients with STEMI/SYNERGY Stent Registry; LoDoCo2: Low Dose Colchicine After Myocardial Infarction; ASSAIL-MI: ASSessing the Effect of Anti-IL-6 Treatment in MI; LATITUDE-TIMI 60: LosmApimod To InhibiT p38 MAP kinase as a therapeUtic target and moDify outcomes after an acute coronary syndrome; VCU-ART3: Virginia Commonwealth University-Anakinra Remodeling Trial-3.