Pan Yannan, Fan Fangfang, Jiang Jie, Zhang Yan
Department of Cardiology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China.
Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.
Inflamm Res. 2025 Jun 30;74(1):99. doi: 10.1007/s00011-025-02058-9.
Treatment effects of anti-inflammatory therapies inhibiting the NLRP3/IL-1β/IL-6/CRP pathway in coronary artery disease (CAD) had conflicting results. The study aims to evaluate efficacy and safety outcomes of treatments inhibiting this pathway.
Cochrane Library, Embase, Pubmed, and ClinicalTrials.gov were searched for randomized controlled trials evaluating therapies inhibiting the NLRP3/IL-1β/IL-6/CRP pathway in CAD patients. Relative risks (RR) with 95% confidence intervals (CI) were calculated.
32 studies and 37,056 individuals were included. Anti-inflammatory therapies inhibiting the pathway reduced the risks of myocardial infarction (MI) (RR 0.85, 95% CI 0.78-0.93) and coronary revascularization (RR 0.80, 95% CI 0.74-0.86), with no benefits in major adverse cardiovascular events (MACE), heart failure (HF), stroke, cardiovascular or all-cause mortality. Colchicine reduced the risks of MACE, MI, and coronary revascularization. IL-1 inhibitors reduced the risks of coronary revascularization, with potential benefits in MI and HF. Increased risks of infections, gastrointestinal adverse effects, and injection site reactions were found. Meta-regression analysis demonstrated that post-treatment hsCRP/CRP was correlated with MACE (p < 0.001) and MI (p = 0.048) and post-treatment IL-6 was associated with MI (p = 0.033).
Anti-inflammatory therapies inhibiting the NLRP3/IL-1β/IL-6/CRP pathway had satisfying safety profiles and were beneficial in preventing MI and coronary revascularization in CAD patients despite no benefits in stroke, cardiovascular, or all-cause mortality.
抑制NLRP3/IL-1β/IL-6/CRP通路的抗炎疗法在冠状动脉疾病（CAD）中的治疗效果存在相互矛盾的结果。本研究旨在评估抑制该通路治疗的疗效和安全性结果。
检索Cochrane图书馆、Embase、Pubmed和ClinicalTrials.gov，以查找评估抑制CAD患者NLRP3/IL-1β/IL-6/CRP通路疗法的随机对照试验。计算相对风险（RR）及95%置信区间（CI）。
纳入32项研究，共37056例个体。抑制该通路的抗炎疗法降低了心肌梗死（MI）风险（RR 0.85，95% CI 0.78 - 0.93）和冠状动脉血运重建风险（RR 0.80，95% CI 0.74 - 0.86），但在主要不良心血管事件（MACE）、心力衰竭（HF）、中风、心血管或全因死亡率方面无益处。秋水仙碱降低了MACE、MI和冠状动脉血运重建风险。IL-1抑制剂降低了冠状动脉血运重建风险，在MI和HF方面可能有益。发现感染、胃肠道不良反应和注射部位反应风险增加。Meta回归分析表明，治疗后hsCRP/CRP与MACE（p < 0.001）和MI（p = 0.048）相关，治疗后IL-6与MI相关（p = 0.033）。
抑制NLRP3/IL-1β/IL-6/CRP通路的抗炎疗法具有令人满意的安全性，尽管在中风、心血管或全因死亡率方面无益处，但对预防CAD患者的MI和冠状动脉血运重建有益。
Zotero 插件
