The primary aim of the Cardiovascular Inflammation Reduction Trial (CIRT) is to determine whether reducing inflammation with low-dose methotrexate can reduce the risk of future heart attacks and strokes among people who have already had one heart attack or have major blockages in their coronary arteries, along with either diabetes or a condition called “metabolic syndrome” that increases the risk of getting diabetes. This randomized, double-blind, placebo-controlled, multi-center trial is in the process of recruiting 7,000 participants throughout the United States and Canada.