Add-on Salsalate Does Not Curb Coronary Plaque in the Overweight

By David Douglas

NEW YORK - Adding salsalate to statins does not affect levels of noncalcified coronary plaque in overweight and obese patients with stable coronary heart disease, researchers have found.

"We previously showed targeting inflammation using salsalate effectively improved glycemia in patients with prediabetes and diabetes," said Dr. Allison B. Goldfine of Joslin Diabetes Center in Boston.

"Thus, we now sought to evaluate the inflammatory hypothesis of atherosclerosis by evaluating whether targeting inflammation using salsalate would slow progression of non-calcified coronary artery plaque volume," she told Reuters Health by email.

For their study, online May 25 in JAMA Cardiology, Dr. Goldfine and colleagues randomized 257 patients to 3.5 g/d of add-on salsalate or placebo. The patients had a mean age of 61 years, and 94% were men.

In the 190 participants who completed the 30-month study, compared with baseline, there was no increase in noncalcified plaque volume in the placebo-treated patients and no difference in change between the salsalate and placebo groups.

Salsalate treatment decreased total white blood cell, lymphocyte, monocyte, and neutrophil counts and increased adiponectin levels without change in C-reactive protein levels.

Thus continued Dr. Goldfine, in "overweight and obese patients with established coronary heart disease, we find that salsalate when added to current therapies that include a statin does not reduce progression of noncalcified coronary plaque volume over 30 months compared with placebo."

"However," she added, "we found no progression of non-calcified plaque volume in our control group. In itself the stability of coronary atherosclerotic lesions is very interesting and supports the high clinical value of multifactorial cardiovascular risk factor management, concordant with the recent epidemiologic trends showing reduced rates of cardiovascular events experienced by our patients."

In an accompanying editorial, Dr. Paul M. Ridke of Brigham and Women's Hospital, Harvard Medical School, Boston, characterized the study as being "an informative neutral trial that deserves our attention."

Among findings of particular interest he added, is that "salsalate reduced neutrophil and lymphocyte counts but did not reduce C-reactive protein level, a pattern of anti-inflammatory effect virtually opposite to that of statins."

SOURCE: https://bit.ly/1t0KFCm and https://bit.ly/24iqIlP

JAMA Cardiol 2016.

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