Recognizing Residual Inflammatory Risk and Preventing Recurrent Events in Patients With Atherosclerotic Cardiovascular Disease
True or False: In patients with residual inflammatory risk, lowering serum levels of C-reactive protein, without altering lipid levels, significantly decreases the incidence of recurrent cardiovascular events.
True. A landmark trial recently demonstrated proof-of-concept for the inflammatory hypothesis by demonstrating that achieving a targeted reduction in serum levels of C-reactive protein, without altering lipid levels, significantly decreases the incidence of recurrent cardiovascular events in patients with residual inflammatory risk.
Ridker PM, et al. N Engl J Med. 2017;377:1119-31.
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Christie M. Ballantyne, MD
Vice Chair of Research, Department of Medicine
Chief, Cardiology and Cardiovascular Research
Professor of Medicine, Molecular and Human Genetics, and Molecular Physiology and Biophysics
Director, The Maria and Alando J. Ballantyne, M.D. Atherosclerosis Clinical Research Laboratory
Director, Center for Cardiometabolic Disease Prevention
Baylor College of Medicine
Paul M. Ridker, MD
Eugene Braunwald Professor of Medicine
Harvard Medical School
Director, Center for Cardiovascular Disease Prevention
Brigham and Women’s Hospital
Clinical Content Manager
Rebecca L. Julian, MS, ELS
Senior Manager, Editorial
Kathryn Schaefer, MSN, RN
Lead Nurse Planner
East Lansing, MI
Upon completion, participants should be able to:
- Describe the inflammatory processes involved in atheroma formation and the use of biomarkers in characterizing patients who have high residual inflammatory risk
- Integrate current clinical evidence regarding strategies for reducing residual inflammatory risk into clinical decision making for patients with chronic atherosclerotic CVD
This activity is intended for cardiologists, internists, and other clinicians who provide routine care for patients at risk of experiencing a recurrent cardiovascular event.
Series Overview/Statement of Need
Inflammation has long been recognized as a key component of the atherogenic cascade resulting in plaque formation, progression, and rupture in coronary artery disease. However, a deepening understanding of the distinctions between residual inflammatory risk and residual cholesterol risk among patients with chronic atherosclerotic cardiovascular disease (ASCVD) is laying the foundation for a paradigm shift in characterizing patients’ risk of recurrent events and tailoring treatment based on patient-specific factors. Several anti-inflammatory therapies are in late-stage clinical trials to investigate their effect on inflammatory biomarker levels and the rate of recurrent cardiovascular events. Furthermore, a landmark trial recently demonstrated proof-of-concept for the inflammatory hypothesis by finding that lowering serum levels of markers of inflammation, in the absence of altered lipid levels, significantly decreases the incidence of recurrent cardiovascular events. To facilitate the translation of cutting-edge evidence to the care of patients with residual inflammatory disease risk, cardiologists must have a sound understanding of how targeting inflammation may affect downstream events, as well as how emerging options may enhance the available treatment armamentarium for this high-risk patient population.
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Medium/Method of Participation
This CME activity consists of a 0.75-credit publication. To receive credit, read the introductory CME material, read the publication, and complete the post-survey, evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly.
Initial Release Date: February 14, 2018
Expiration Date: February 13, 2019
Estimated Time to Complete This Activity: 45 minutes
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The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been resolved through an established COI resolution process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation.
Christie M. Ballantyne, MD
Consulting fees/advisory boards: Abbott Laboratories, Amarin, Amgen, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Esperion, F. Hoffman La-Roche Ltd., Ionis Pharmaceuticals, Inc., Matinas BioPharma Holdings, Inc., Merck & Co., Inc., Novartis Pharmaceuticals Corporation, Pfizer, Inc., Regeneron Pharmaceuticals, Inc., Sanofi-aventis U.S. Inc.
Paul M. Ridker, MD
Consulting fees/advisory boards: AstraZeneca, QuintilesIMS, Sanofi-aventis U.S. Inc., Teva Pharmaceuticals Industries Ltd.
Contracted research: Amgen, AstraZeneca, Kowa Pharmaceuticals America, Inc., Novartis Pharmaceuticals Corporation, Pfizer, Inc.
Other: AstraZeneca, Siemens Corporation
The peer reviewers and activity planners have no financial relationships to disclose.
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This activity is supported by an educational grant from Novartis Pharmaceuticals Corporation.
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