Next Article in Journal
Fatal Free Falls: A Clinical and Forensic Analysis of Skeletal Injury Patterns Using PMCT and Autopsy
Previous Article in Journal
Pathway-Specific Therapeutic Modulation of Melanoma: Small-Molecule Inhibition of BRAF–MEK and KIT Signaling in Contemporary Precision Oncology with a Special Focus on Vemurafenib, Trametinib, and Imatinib
Previous Article in Special Issue
The Platelet-to-Hemoglobin Ratio as a Prognostic Marker in Patients with Diabetes Mellitus and Acute Coronary Syndrome
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
JCM
Volume 14
Issue 22
10.3390/jcm14227910
jcm-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Review

Beyond Lipids and Platelets: A Review of Anti-Inflammatory Strategies in Secondary Prevention of Acute Coronary Syndromes

by
Girish Pathangey
*,
Mohamed N. Allam
,
Mahmoud H. Abdelnabi
,
Dan Sorajja
*,
Floyd David Fortuin
,
Kwan S. Lee
and
Mayurkumar D. Bhakta
Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA
*
Authors to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(22), 7910; https://doi.org/10.3390/jcm14227910
Submission received: 22 September 2025 / Revised: 23 October 2025 / Accepted: 28 October 2025 / Published: 7 November 2025
(This article belongs to the Special Issue Advances in Diagnosis, Risk Stratification, and Personalized Management in Acute Coronary Syndromes)
Versions Notes

Abstract

Despite advances in lipid-lowering and antithrombotic therapy, patients with acute coronary syndromes remain at elevated risk for recurrent events due to persistent atherosclerotic inflammation. This review evaluates inflammation as a therapeutic target in secondary prevention and discusses established, investigational, and emerging strategies. Colchicine, now FDA-approved for cardiovascular risk reduction, lowered major adverse cardiovascular events in COLCOT and LoDoCo2. Canakinumab (IL-1β inhibition) reduced recurrent events in proportion to IL-6 and hsCRP suppression, while ziltivekimab (IL-6 inhibition) achieved profound biomarker reductions but remains investigational. Early-phase studies of anakinra (IL-1 receptor antagonist) and dapansutrile (oral NLRP3 inhibitor) showed anti-inflammatory effects in early trials, whereas varespladib and darapladib illustrated the challenges of targeting lipid-associated pathways. Beyond direct immunomodulators, GLP-1 receptor agonists and SGLT2 inhibitors provide both cardioprotective and anti-inflammatory benefits, reinforcing their expanding role post-ACS. Additional emerging avenues include triptolidiol, dasatinib, and BTK or JAK/STAT inhibitors, while novel approaches, such as nanozyme delivery systems and CRISPR-based editing, extend the therapeutic horizon. This review highlights the potential of inflammation-targeted therapies to advance secondary prevention in ACS by integrating current evidence and perspectives on future therapeutic developments.
Keywords: acute coronary syndromes; atherosclerosis; plaque inflammation; residual risk; biomarkers; hsCRP; IL-6; NLRP3 inflammasome; immunomodulation; anti-inflammatory therapy; cardiometabolic therapies; GLP-1 receptor agonists; SGLT2 inhibitors; precision medicine; secondary prevention; acute myocardial infarction; coronary artery disease; translational research; novel therapeutics acute coronary syndromes; atherosclerosis; plaque inflammation; residual risk; biomarkers; hsCRP; IL-6; NLRP3 inflammasome; immunomodulation; anti-inflammatory therapy; cardiometabolic therapies; GLP-1 receptor agonists; SGLT2 inhibitors; precision medicine; secondary prevention; acute myocardial infarction; coronary artery disease; translational research; novel therapeutics

Share and Cite

MDPI and ACS Style

Pathangey, G.; Allam, M.N.; Abdelnabi, M.H.; Sorajja, D.; Fortuin, F.D.; Lee, K.S.; Bhakta, M.D. Beyond Lipids and Platelets: A Review of Anti-Inflammatory Strategies in Secondary Prevention of Acute Coronary Syndromes. J. Clin. Med. 2025, 14, 7910. https://doi.org/10.3390/jcm14227910

AMA Style

Pathangey G, Allam MN, Abdelnabi MH, Sorajja D, Fortuin FD, Lee KS, Bhakta MD. Beyond Lipids and Platelets: A Review of Anti-Inflammatory Strategies in Secondary Prevention of Acute Coronary Syndromes. Journal of Clinical Medicine. 2025; 14(22):7910. https://doi.org/10.3390/jcm14227910

Chicago/Turabian Style

Pathangey, Girish, Mohamed N. Allam, Mahmoud H. Abdelnabi, Dan Sorajja, Floyd David Fortuin, Kwan S. Lee, and Mayurkumar D. Bhakta. 2025. "Beyond Lipids and Platelets: A Review of Anti-Inflammatory Strategies in Secondary Prevention of Acute Coronary Syndromes" Journal of Clinical Medicine 14, no. 22: 7910. https://doi.org/10.3390/jcm14227910

APA Style

Pathangey, G., Allam, M. N., Abdelnabi, M. H., Sorajja, D., Fortuin, F. D., Lee, K. S., & Bhakta, M. D. (2025). Beyond Lipids and Platelets: A Review of Anti-Inflammatory Strategies in Secondary Prevention of Acute Coronary Syndromes. Journal of Clinical Medicine, 14(22), 7910. https://doi.org/10.3390/jcm14227910

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop