Icy heart melting under warm light, symbolizing inflammation reduction in heart disease.

Inflammation's Silent Threat: Can We Prevent Heart Attacks by Targeting It?

Elliot Brynn in Health & Wellness December 2025 • 4 min read.

"Landmark study reveals a new approach to heart disease prevention by reducing inflammation, offering hope for those at risk."

For years, the fight against heart disease has largely focused on lowering cholesterol. But what if there's another, equally important factor at play? Mounting evidence suggests that inflammation, the body's response to injury or irritation, plays a critical role in the development of atherosclerosis, the hardening of the arteries that leads to heart attacks and strokes. But can reducing inflammation alone make a difference, especially for those already managing their cholesterol?

A recent study, the Canakinumab Antiinflammatory Thrombosis Outcome Study (CANTOS), sheds light on this very question. Published in the New England Journal of Medicine, this landmark trial explored whether canakinumab, a drug that specifically targets interleukin-1β (a key driver of inflammation), could prevent recurrent cardiovascular events.

The CANTOS trial offers a new perspective on heart disease prevention, moving beyond traditional cholesterol-lowering strategies to explore the potential of anti-inflammatory therapies. Let's delve into the study's findings, what they mean for those at risk, and the exciting possibilities they unlock for the future of heart health.

CANTOS: A New Path to Heart Health?

Icy heart melting under warm light, symbolizing inflammation reduction in heart disease.

The CANTOS trial enrolled over 10,000 patients who had previously experienced a myocardial infarction (heart attack) and had elevated levels of high-sensitivity C-reactive protein (hsCRP), a marker of inflammation. These patients, despite often receiving standard treatments like statins to lower cholesterol, remained at high risk for future cardiovascular events.

The study compared the effects of different doses of canakinumab (50mg, 150mg, and 300mg, administered every 3 months) against a placebo. The primary goal was to determine if canakinumab could reduce the risk of:

Nonfatal myocardial infarction
Nonfatal stroke
Cardiovascular death

After nearly four years of follow-up, the results revealed a significant benefit with the 150mg dose of canakinumab. Patients receiving this dose experienced a 15% reduction in the risk of the primary endpoint compared to the placebo group. This dose also significantly reduced the risk of a secondary endpoint that included hospitalization for unstable angina requiring urgent revascularization (procedures to restore blood flow to the heart).

Implications and the Future of Heart Health

The CANTOS trial provides compelling evidence that inflammation is a key player in heart disease and that targeting it can lead to significant benefits, even without lowering cholesterol. This opens up new avenues for prevention and treatment, particularly for those who remain at high risk despite traditional therapies.

It's important to note that canakinumab was associated with a higher risk of fatal infections. Further research is needed to identify who might benefit most from this approach and to develop safer anti-inflammatory therapies.

The CANTOS trial marks a turning point in our understanding and treatment of heart disease. By acknowledging and addressing the role of inflammation, we can potentially save more lives and pave the way for a future where heart attacks are far less common.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1056/nejmoa1707914, Alternate LINK

Title: Antiinflammatory Therapy With Canakinumab For Atherosclerotic Disease

Subject: General Medicine

Journal: New England Journal of Medicine

Publisher: Massachusetts Medical Society

Authors: Paul M Ridker, Brendan M. Everett, Tom Thuren, Jean G. Macfadyen, William H. Chang, Christie Ballantyne, Francisco Fonseca, Jose Nicolau, Wolfgang Koenig, Stefan D. Anker, John J.P. Kastelein, Jan H. Cornel, Prem Pais, Daniel Pella, Jacques Genest, Renata Cifkova, Alberto Lorenzatti, Tamas Forster, Zhanna Kobalava, Luminita Vida-Simiti, Marcus Flather, Hiroaki Shimokawa, Hisao Ogawa, Mikael Dellborg, Paulo R.F. Rossi, Roland P.T. Troquay, Peter Libby, Robert J. Glynn

Published: 2017-09-21

Everything You Need To Know

What is inflammation and why is it relevant to heart health?

Inflammation is the body's natural response to injury or irritation. In the context, it's presented as a critical factor in the development of atherosclerosis, which is the hardening of arteries. This process can lead to heart attacks and strokes. The research underscores that inflammation, alongside cholesterol levels, plays a significant role in cardiovascular health.

What was the CANTOS trial?

The CANTOS trial, or Canakinumab Antiinflammatory Thrombosis Outcome Study, investigated the effects of canakinumab on heart health. It specifically examined whether this drug, which targets interleukin-1β (a key driver of inflammation), could reduce recurrent cardiovascular events in patients. This study is significant because it explores a new approach to heart disease prevention by addressing inflammation directly rather than solely focusing on cholesterol.

What were the main findings of the CANTOS trial?

The major findings of the CANTOS trial showed that the 150mg dose of canakinumab led to a 15% reduction in the risk of the primary endpoint, which included nonfatal myocardial infarction, nonfatal stroke, and cardiovascular death. This dose also decreased the risk of secondary endpoints, such as hospitalization for unstable angina requiring urgent revascularization. This means that by targeting inflammation with canakinumab, the study demonstrated a reduction in the occurrence of future heart-related events.

What is canakinumab and what does it do?

Canakinumab is a drug that specifically targets interleukin-1β. Interleukin-1β is a key component of inflammation. By blocking it, canakinumab helps to reduce the inflammatory process in the body. This action helps to prevent cardiovascular events, independent of the cholesterol levels.

What are the implications of the CANTOS trial for the future of heart health?

The implications of the CANTOS trial are substantial. It offers a new perspective on heart disease prevention, suggesting that targeting inflammation can lead to significant benefits. This is particularly important for those at high risk who may not be fully protected by traditional cholesterol-lowering therapies. This opens up possibilities for new treatments and strategies for improving heart health.