Front Med (Lausanne). 2026 Sep 10;13:1882786. doi: 10.3389/fmed.2026.1882786. eCollection 2026.
ABSTRACT
BACKGROUND: Identifying and treating inflammation is a recommended atherosclerotic cardiovascular disease (ASCVD) prevention strategy. The practice of screening for and treating inflammation is unknown. This study examined screening for inflammation and treatment with colchicine among patients with established ASCVD.
METHODS: Using the Epic COSMOS electronic health record (EHR) database, we compared adults with known ASCVD between two time frames: (1) 2023 (colchicine FDA approved for ASCVD prevention) until April 2026 and (2) September 2025 [American College of Cardiology (ACC) scientific statement released] until April 2026. We examined screening for inflammation and treatment of inflammation. Chi-square tests compared differences before and after the ACC scientific statement on inflammation.
RESULTS: The study contained 13.5 million adults aged 18 years or older diagnosed within the EHR with ASCVD. Only 1.2% of the patients with ASCVD were on colchicine. The proportion of patients with known ASCVD who were screened to assess inflammation was also very low (3.1%). Among patients who had hs-CRP measurements, 65.3% had elevated levels. Additionally, even in light of documented inflammation, the proportion of patients with elevated documented inflammation are on colchicine was low but did increase after the ACC scientific statement from 2.1% to 2.9%.
CONCLUSION: The evidence on inflammation and its role in ASCVD is substantial. Screening for inflammation and treatment of the inflammation pathway in patients with ASCVD is very low and not consistent with evidence-based practice.
PMID:42787013 | PMC:PMC13600809 | DOI:10.3389/fmed.2026.1882786