Updating concepts on atherosclerotic inflammation: from pathophysiology to treatment

BACKGROUND: Atherosclerosis is recognized as a systemic low-grade inflammatory disease. Furthermore, the dysregulation of the inflammatory response and its timely resolution is a pivotal process in determining the clinical manifestations of cardiac and cerebral acute ischemia following atherothrombosis.METHODS: This narrative review is based on the material searched on PubMed up to October 2020. The search terms we used were: "atherosclerosis, inflammation, acute myocardial infarction and ischemic stroke" in combination with "biomarker, inflammatory cells and molecules, treatment."RESULTS: The expected goal of addressing inflammation for the treatment of atherosclerosis and its acute ischemic complications is reducing mortality and morbidity related to atherosclerotic cardiovascular disease, which are currently the first cause of death and disability worldwide. In this narrative review, we summarize the evidence about the main cellular and molecular mechanisms inflammation in atherogenesis, atherothrombosis and acute ischemic complications, with particular focus on the potential molecular targets for novel pharmacological treatments.CONCLUSION: Although a large amount of evidence in animal models of atherotrombotic disease, and the promising results of clinical trials, targeting inflammation for atherosclerotic cardiovascular disease is not yet an actual treatment option for the present time or the upcoming future. A deepest understanding of pathophysiological mechanisms underlying the mechanisms driving resolution of the acute inflammation will probably allow to identify the optimal molecular target.