Davison, Beth AAbbate, AntonioCotter, GadPascual-Figal, DomingoVan Tassell, BenjaminVillota, Julio NúñezAtabaeva, LinaFreund, YonathanAimo, AlbertoBiegus, JanGolino, MicheleDel Buono, Marco GiuseppeChioncel, OvidiuCohen-Solal, AlainEdwards, ChristopherFernández-Villa, NoeliaFilippatos, GerasimosGonzález-Juanatey, José RamónHayrapetyan, HamletIbáñez, BorjaIborra, Pau LlàcerMoroni, FrancescoTer Maaten, Jozine MMarkley, RoshanakGonzález-Martín, JavierMartínez-Sellés, ManuelDrambyan, MayranushMetra, MarcoMirabet, SoniaMshetsyan, AndranikNovosadova, MariaPagnesi, MatteoPonikowski, PiotrRiquelme-Pérez, AlejandroSadoune, MalhaSánchez, Manuel AnguitaSimon, TabassomeTaibo-Urquía, MikelTakagi, KojiVillar, SandraLiu, ChaoVoors, Adriaan AMebazaa, AlexandreMann, Douglas LBayés-Genís, Antoni2025-12-172025-12-172025-05Heart Fail Rev. 2025 May;30(3):575-587.https://hdl.handle.net/20.500.12105/27066We examined current evidence regarding the effects of anti-inflammatory therapies in patients with acute heart failure (AHF) on the risk of cardiovascular outcomes, inflammatory markers, natriuretic peptides, and renal function. Despite growing evidence that inflammation plays a pivotal role in both the development and progression of heart failure, including AHF, only a few trials have been conducted to date in patients with AHF. A systematic literature search of PubMed, Medline, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov was conducted in November 2024 to identify randomized controlled trials (RCTs) evaluating anti-inflammatory therapies in adult patients with AHF. Meta-analyses were conducted to estimate effects on clinical outcomes (death, HF readmission, or worsening HF) and inflammatory and other markers. Five RCTs were identified that enrolled a total of 289 patients to an anti-inflammatory intervention and 273 to a control. Prednisone was examined in two RCTs, anakinra in two, and colchicine in one. Three of the five trials required elevated C-reactive protein (CRP) level for entry. Anti-inflammatory therapy was associated with a reduced risk of the composite outcome (hazard ratio 0.55 [95% CI 0.35-0.86]) and an overall 54% greater reduction in CRP to end of therapy (ratio of geometric mean ratios 0.46 [95% CI 0.29-0.73]), which varied across studies. NT-proBNP and creatinine were not significantly affected. The analysis is limited by the small number of studies but suggests that anti-inflammatory therapy reduces inflammation and may reduce the risk of adverse clinical outcomes in patients with AHF.engVoRhttp://creativecommons.org/licenses/by-nc-nd/4.0/Acute heart failureAnti-inflammatory agentsInflammationPrognosisAttribution-NonCommercial-NoDerivatives 4.0 International39939545HEART FAILURE REVIEWSopen access