CV Inflammation
The Role of Inflammation in ASCVD
Inflammation drives plaque formation and progression in Atherosclerotic Cardiovascular Disease (ASCVD), increasing the risk of heart attacks and strokes, the leading cause of death in the U.S.
Is your residual inflammatory risk being treated?
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What is residual inflammatory risk?
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Residual risk, is the risk of cardiac events (heart attacks, strokes etc.) that patients are still exposed to despite the lifestyle changes and medicines they are already taking to lower their cholesterol levels or blood pressure.
Residual inflammatory risk, is the risk of a heart attack or stroke patients are still exposed to due to untreated inflammation in the cardiovascular system.
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It’s widely understood that inflammation increases cardiovascular (CV) risks, independently from high cholesterol [3]. Residual inflammatory risk is associated with a significant increase in the risk of heart attack, stroke, and all-cause mortality [4].
Almost half of all patients on aggressive statin therapy have residual inflammatory risk [5].
How is Residual Inflammatory Risk Determined?
Residual inflammatory risk refers to the inflammation in your body that might still be present even if your cholesterol levels are well controlled, which can cause heart issues.
Doctors often check for this using a High-Sensitivity C-Reative Protein (hs-CRP) test that look for signs of inflammation.
hs-CRP Value
< 1 mg/L
1 - 3 mg/L
> 3 mg/L
Cardiovascular Disease Risk
Low Risk
Average Risk
High Risk
High-Sensitivity C-Reactive Protein (hs-CRP)
What it is: A blood test that measures a protein made by the liver in response to inflammation.
Knowing your residual inflammatory risk helps doctors decide if more treatment is needed
Even with controlled cholesterol, inflammation can still raise heart risk
Inflammation is more Important than Cholesterol
A recent study analyzing over 31,000 patients on statins, a cholesterol lowering medication, found that inflammation can be more important than cholesterol in predicting heart problems and death.
Lowest Risk
Low Cholesterol
Low Inflammation
Moderate Risk
High Cholesterol
Low Inflammation
Highest Risk
High Cholesterol
High Inflammation
High Risk
Low Cholesterol
High Inflammation
Risk of Heart Problems
Lowest Risk
Slightly Higher Risk
1.3x Higher Risk
1.5x Higher Risk
Risk of Death from Heart Disease
Lowest Risk
Slightly Higher Risk
1.5x Higher Risk
2x Higher Risk
Even with statins controlling cholesterol, the study shows that uncontrolled inflammation significantly increases heart risk, highlighting inflammation as a powerful predictor of heart problems and death.
Do I have inflammation?
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Even if cholesterol levels remain low in the blood, if inflammation levels are high, the risk of developing heart disease is still 1.5 times higher than that of healthy people.
References
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[1] Everett B, et al. Residual Inflammatory Risk. J Am Coll Cardiol. 2019 May, 73 (19) 2410–2412. https://doi.org/10.1016/j.jacc.2019.02.056
[2] Ornato, J. P., & Hand, M. M. (2014). Warning signs of a heart attack. Circulation, 129(11), e393-e395.
[3] Paul M Ridker, Deepak L Bhatt, Aruna D Pradhan, Steven E Nissen, et al. Inflammation and cholesterol as predictors of cardiovascular events among patients receiving statin therapy: a collaborative analysis of three randomised trials. The Lancet. Published online March 6, 2023. Vol. 401, issue 10384, P1293-1301, April 15, 2023.
[4] Ridker PM. How Common Is Residual Inflammatory Risk? Circ Res. 2017 Feb 17;120(4):617-619. doi: 10.1161/CIRCRESAHA.116.310527. PMID: 28209792.
[5] Ridker, P. M., Bhatt, D. L., Pradhan, A. D., Glynn, R. J., MacFadyen, J. G., & Nissen, S. E. (2023). Inflammation and cholesterol as predictors of cardiovascular events among patients receiving statin therapy: a collaborative analysis of three randomised trials. The Lancet, 401(10384), 1293-1301.
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