Ilana S Nazari, Samuel A McFarlane, Meena S Madhur, Allison E Norlander, Edward B Thorp, Matthew J Feinstein
Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality worldwide despite major advances in risk factor attenuation and lipid-lowering therapies. Inflammation is a central driver of atherosclerosis, contributing to disease initiation, progression, and excess cardiovascular risk. This article summarizes the pathophysiology of atherosclerosis with a focus on the inflammatory mechanisms underlying plaque development and instability, anti-inflammatory therapeutic strategies, and the emerging role of epigenetic and metabolic programming of innate immune cells in perpetuating unresolved inflammation.