RE:Important news on inflammation and cardiovascular disease The totality of these findings highlight the importance of systemic and arterial inflammation for risk of major adverse cardiovascular events. We should be using biomarkers, such as hs-CRP, and building on that with better ones that provide an index for body-wide inflammation. We have a cheap drug that has proven efficacy in 6 randomized trials—colchicine. It’s hardly used by cardiologists or physicians in general to reduce risk. The proprietary form of the drug (LoDoCo) is 0.5 mg (once per day) as assessed in the trials, but the generic 0.6 mg, which should have the same effect, is less than 1/20th of the price (GoodRx $300 vs $15). The problem with colchicine is that it frequently induces gastrointestinal side effects, particularly diarrhea, in about 1 in 4 people. We clearly need better anti-inflammatory agents with higher efficacy and less side effects. But little work is being done to pursue this goal.
The big miss is that we continue to be focused only on lipid lowering and flow-limiting atherosclerotic narrowings, without adequate attention to detecting inflammation, using anti-inflammatory agents (that are not lipid directed), and acknowledging the adverse prognostic potential of non-obstructive arterial disease. The evidence has mounted to change course and adapt a broader view that will help reduce major adverse cardiovascular events in people at-risk.
The Big Miss: Inflammation and Cardiovascular Disease (substack.com)