Platelets as therapeutic targets to prevent atherosclerosis

Area of Science:

• Cardiovascular Research
• Immunology
• Hematology

Background:

• Cardiovascular disease is a leading global cause of death, necessitating effective primary prevention strategies.
• Platelets are implicated in atherosclerosis initiation, progression, and thrombotic complications.
• Current antiplatelet therapy guidelines lack consensus for primary cardiovascular disease prevention due to bleeding risks.

Purpose of the Study:

• To review the multifaceted role of platelets in atherosclerosis.
• To explore platelet interactions with lipids, endothelium, and immune cells in vascular inflammation.
• To identify potential therapeutic targets in platelet function beyond aggregation for primary prevention.

Main Methods:

• Literature review focusing on platelet roles in atherosclerosis.
• Analysis of platelet-lipid, platelet-endothelium, and platelet-immune cell interactions.
• Examination of complement-platelet interplay in atherosclerotic plaque.

Main Results:

• Platelets actively contribute to vascular inflammation and atherosclerosis progression.
• Platelets mediate recruitment of monocytes, neutrophils, and dendritic cells.
• Platelet functions influence tissue homeostasis and plaque microenvironment.
• Complement system interacts with platelets in atherosclerosis.

Conclusions:

• Platelets are central to atherosclerosis pathogenesis, not just thrombosis.
• Targeting platelet functions distinct from aggregation may mitigate bleeding risks.
• Novel antiplatelet strategies could restore a role in primary cardiovascular disease prevention.