ACC Scientific Statement: Inflammation and Cardiovascular Disease Consensus
ACC Scientific Statement: Inflammation and Cardiovascular Disease Consensus
(Source: ACC Medical News release, October 2, 2025, summarizing JACC publication from September 29, 2025)
Keynotes :
1. Inflammation is now a proven, treatable risk factor in CVD.
– The ACC consensus confirms that inflammation plays a central role in coronary artery disease, heart failure, and atherosclerosis.
– Evidence is no longer exploratory but clinically actionable.
2. Routine inflammation screening is strongly recommended.
– The statement emphasizes high-sensitivity C-reactive protein (hsCRP) testing for all patients, in both primary and secondary prevention.
– hsCRP ≥2 mg/L indicates elevated inflammatory risk, even when LDL-C is controlled with statins.
– hsCRP is as predictive of events as LDL-C, particularly in treated patients.
3. Lifestyle interventions remain first-line anti-inflammatory therapy.
– 150 minutes of weekly exercise, Mediterranean or DASH diet, and omega-3 (EPA/DHA) intake are recommended.
– These align with the 2025 ACC/AHA Hypertension Guidelines.
4. Colchicine becomes first approved anti-inflammatory therapy for coronary disease.
– Low-dose colchicine reduces cardiovascular events in chronic atherosclerosis when used in addition to statins.
– It should not be started during acute ischemia and is contraindicated in significant liver or kidney disease.
5. Therapeutic recommendations in residual inflammation:
– If hsCRP >2 mg/L despite statins, consider If hsCRP remains >2 mg/L despite optimal LDL-C therapy, ensure high-intensity statin use and consider adjunct anti-inflammatory therapy (e.g., low-dose colchicine).
– Colchicine is now FDA-approved (2023) as the first on-label anti-inflammatory for chronic coronary inflammation who have persistent vascular inflammation (hsCRP >2 mg/L) despite optimal lipid-lowering therapy.
– Ongoing trials are evaluating IL-6 inhibitors and novel bioactive lipid mediators for inflammation resolution.
6. Research gaps and future directions:
– Some anti-inflammatory trials have failed in secondary prevention.
– More evidence is needed to understand inflammation’s interaction with other physiological systems (renal, metabolic, endothelial).
7. Key message:
The ACC urges clinicians to incorporate hsCRP screening routinely and to consider anti-inflammatory strategies, including lifestyle optimization, colchicine, and emerging biologics, as part of comprehensive cardiovascular prevention.
