Cardiopulmonary MedicineORIGINAL ARTICLE

The role of aspirin, statins, colchicine, and IL-1 inhibitors in prevention of cardiovascular events: a systematic integrative review

Vania Arboleda, BS; Ashley Hackworth, MS; Sabrina Bonnice, BS; Vivianne Gonzalez, MS; Dominick Cabrera, MS; Craig Colletti, BS; Courtney Baxter, BA; Claudia Aleman Oliva, BS; Shadman Kabir, BS; Jing Huang, BS; Ashar Khan, BS; Stefanie Filoramo, MS; Sara Ecoff, MS; Michelle Demory Beckler, PhD; and Marc M. Kesselman, DO
Notes and Affiliations
Notes and Affiliations

Received: April 10, 2023

Accepted: September 26, 2023

Published: October 25, 2023

  • Vania Arboleda, BS, 

    Nova Southeastern University, Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL, USA

  • Ashley Hackworth, MS, 

    Nova Southeastern University, Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL, USA

  • Sabrina Bonnice, BS, 

    Nova Southeastern University, Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL, USA

  • Vivianne Gonzalez, MS, 

    Nova Southeastern University, Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL, USA

  • Dominick Cabrera, MS, 

    Nova Southeastern University, Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL, USA

  • Craig Colletti, BS, 

    Nova Southeastern University, Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL, USA

  • Courtney Baxter, BA, 

    Nova Southeastern University, Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL, USA

  • Claudia Aleman Oliva, BS, 

    Nova Southeastern University, Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL, USA

  • Shadman Kabir, BS, 

    Nova Southeastern University, Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL, USA

  • Jing Huang, BS, 

    Nova Southeastern University, Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL, USA

  • Ashar Khan, BS, 

    Nova Southeastern University, Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL, USA

  • Stefanie Filoramo, MS, 

    Nova Southeastern University, Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL, USA

  • Sara Ecoff, MS, 

    Nova Southeastern University, Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL, USA

  • Michelle Demory Beckler, PhD, 

    Division of Immunology, Nova Southeastern University, Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, FL, USA

  • Marc M. Kesselman, DO, 

    Division of Rheumatology, Nova Southeastern University, Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL, USA

J Osteopath Med; 124(3): 97-106
Abstract

Context: Cardiovascular disease (CVD) is the leading cause of death in the United States. As such, an unmet need exists in the primary and secondary prevention of adverse cardiovascular events (CVEs). Specifically, identifying drugs that can reduce the progression of CVD and serious adverse events is much needed. Drugs that work by reducing platelet aggregation, blocking cholesterol formation (3-hydroxy-3-methyl-glutaryl-coenzyme A [HMG-CoA] reductase inhibitors), and/or blocking inflammation pathways (mainly interleukin-1b [IL-1b]) have been linked to preventing adverse CVEs, including acetylsalicylic acid (ASA, aspirin), statins, colchicine, and IL-1 inhibitors (interleukin-1 receptor antagonists). This systematic review aims to provide insight into utilizing these four agents for the primary and/or secondary prevention of CVD.

Objectives: In this systematic review, we opted to review the efficacy of aspirin, statins, colchicine, and IL-1 inhibitors in the primary and secondary prevention of CVE to provide clinical practitioners with evidence-based practice approaches and determine any unmet needs in their utilization.

Methods: Between October 1 and 12, 2021, a search was conducted and completed on five databases: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and Biomedical Reference Collection: Comprehensive. A total of 13 researchers (V.A., A.H., S.B., V.G., D.C., C.C., C.B., C.A., S.K., J.H., A.K., S.F., and S.E.) were involved in the search and screening of the articles. Search terms included “aspirin, statins, colchicine, IL-1 inhibitors, and primary, secondary, myocardial infarction (MI).” Inclusion criteria included clinical study design, English language articles, all genders older than 50 years old, and established patient history of CVD, including MI. In addition, articles were excluded if they were animal models, in vitro studies, pharmacokinetic studies, systematic reviews, literature reviews, and studies exploring therapies other than those listed in the inclusion criteria. First, five individuals independently sorted through abstracts or articles based on the inclusion and exclusion criteria. Then, a team of 13 individuals sorted through full-text articles of selected abstracts based on the same criteria. A separate researcher resolved conflicts between the team.

Results: A total of 725 articles were identified from all databases, from which 256 duplicated articles were removed. Thus, a total of 469 articles abstracts were screened, of which 425 articles either did not meet the inclusion criteria or met the exclusion criteria. A total of 42 articles were retrieved and assessed for full-text review, from which 15 articles were retrieved for analysis.

Conclusions: Statins may prevent primary CVEs based on their role in preventing cholesterol formation. Aspirin, canakinumab, and colchicine may be helpful in the secondary prevention of CVEs due to their blocking of various steps in the inflammation pathway leading to CVD. Future research should primarily focus on the use of canakinumab and colchicine in preventing CVD due to the limited number of studies on these drugs.

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