Cardiac protection by pharmacological modulation of inflammation

Inflammation is a reaction to primary injury of various kinds, such as infe ction and trauma, which has both beneficial and detrimental effects. inflam mation has been associated with major diseases of the heart and vessels. Re search has focused not only on ischaemia but also on post-ischaemic reperfu sion, which is known to activate and amplify the inflammatory response. Alt hough reperfusion should always be attempted in the clinical environment, i t has been shown experimentally that it can cause some cardiac damage, in a ddition to that caused by ischaemia. Therefore, it is reasonable to attempt to increase the benefit obtainable with reperfusion by modulating inflamma tory processes triggered by reperfusion itself. In this field, different po tential therapeutic targets have been identified and interventions have bee n tested over the last 30 years. With the exception of adenosine, which pro bably does not act merely through inhibition of the inflammatory response, no other compounds have yet proven successful in clinical trials. Active re search is ongoing. Broadening the approach from the heart to the cardiovasc ular system, promising data is emerging on cardiovascular protection confer red by statins in patients with coronary heart disease (CHD) and high level s of C-reactive protein (CRP), a systemic marker of inflammation. Similarly , results of trials aimed at preventing cardiovascular events by eradicatin g chronic infections will be among the first to directly test whether such therapies will decrease risks of cardiovascular disease.