Inflammation contributes to atherosclerotic progression and recurrent cardiovascular events in patients with coronary artery disease (CAD). Anti-inflammatory therapies have therefore been explored as potential adjunctive strategies for secondary prevention in patients with acute coronary syndromes (ACS) and stable CAD. A systematic review and Bayesian network meta-analysis published in Frontiers in Cardiovascular Medicine evaluated the comparative effectiveness of anti-inflammatory medications in reducing major adverse cardiovascular events (MACE).
Multiple databases, including Medline,

Embase, the Cochrane Central Register of Controlled Trials, clinical trial registries, Europe PMC, and conference abstracts, were searched for randomized controlled trials evaluating anti-inflammatory therapies in CAD populations. Studies were eligible if they included at least one anti-inflammatory treatment arm and enrolled patients with ACS or stable CAD. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool.

From 17,021 screened records, 41 randomized trials met inclusion criteria. The ACS network included 29,487 patients, while the stable CAD network included 41,791 patients. In the ACS network, non-steroidal anti-inflammatory drugs (NSAIDs) (odds ratio [OR] 0.30; 95% credible interval [CrI] 0.11-0.74) and colchicine (OR 0.77; CrI 0.62-0.95) were associated with lower risk of MACE compared with control. In the stable CAD network, colchicine (OR 0.65; CrI 0.54–0.77) and corticosteroids (OR 0.44; CrI 0.26-0.72) were associated with lower MACE risk.

Anti-inflammatory therapies showed varying associations with cardiovascular outcomes across CAD populations. Evidence for several treatments was influenced by indirect comparisons and should be interpreted accordingly.