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Plaque burden, microstructures and compositions underachieving very low LDL-C levels

Yu Kataoka1, Jordan Andrews, Rishi Puri

  • 1aDepartment of Cardiovascular Medicine National Cerebral & Cardiovascular Centre, Suita, Japan bHeart Health, South Australian Health & Medical Research Institute, University of Adelaide, Adelaide, Australia cQuebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada.

Current Opinion in Endocrinology, Diabetes, and Obesity
|January 21, 2017
PubMed
Abstract

Insights

Lowering low-density lipoprotein cholesterol (LDL-C) slows atherosclerotic plaque progression and alters its composition. Achieving very low LDL-C levels with statins promotes plaque regression and improves cardiovascular outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Atherosclerosis Research
  • Lipid Metabolism

Background:

  • Low-density lipoprotein cholesterol (LDL-C) is a primary target for preventing atherosclerotic cardiovascular disease.
  • Intravascular imaging techniques have provided in vivo evidence of LDL-C lowering's antiatherosclerotic effects.

Purpose of the Study:

  • To review the impact of reducing LDL-C on atherosclerotic plaque progression.
  • To examine how LDL-C lowering affects plaque microstructures and compositions.
  • To synthesize current understanding of LDL-C's role in managing cardiovascular disease.

Main Methods:

  • Review of studies utilizing intravascular imaging to assess atherosclerotic plaques.
  • Analysis of data on the effects of statin therapy and intensive LDL-C control.
  • Synthesis of findings related to plaque progression, microstructure, and composition changes.

Main Results:

  • Intensive LDL-C control, particularly with statins, significantly slows plaque progression.
  • Achieving very low LDL-C levels can induce atherosclerotic plaque regression.
  • Lowering LDL-C modulates plaque microstructures and alters lipid and inflammatory compositions.

Conclusions:

  • Lowering LDL-C is a cornerstone therapy for primary and secondary prevention of cardiovascular events.
  • Mechanistic insights from intravascular imaging confirm the benefits of LDL-C reduction.
  • This review consolidates evidence on LDL-C's multifaceted impact on atherosclerotic disease.

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