Working towards full eradication of lipid-driven cardiovascular risk?

Area of Science:

• Cardiology and Lipidology
• Pharmacology and Therapeutics

Background:

• Lipid-driven cardiovascular disease (CVD) risk stems from atherogenic apolipoprotein B (apoB) particles, including LDL-C, triglycerides, and Lp(a).
• Despite advancements in lipid-lowering therapies, CVD risk management in the Netherlands remains suboptimal.
• Current standard therapies for lowering LDL-C include statins, ezetimibe, and PCSK9 inhibitors.

Purpose of the Study:

• To review current and emerging therapeutic strategies for managing lipid-driven CVD risk.
• To highlight the expanding options for lowering LDL-C, triglycerides, and Lp(a).
• To discuss the potential of novel therapies to eradicate apoB-particle-driven CVD risk.

Main Methods:

• Review of current lipid-lowering therapies (statins, ezetimibe, PCSK9 inhibitors).
• Discussion of recently approved agents like bempedoic acid and inclisiran.
• Exploration of emerging treatments for triglycerides (pemafibrate, apoC-III inhibitors) and Lp(a) (pelacarsen).

Main Results:

• Therapeutic options for lowering LDL-C are continuously expanding.
• Triglyceride-lowering therapies show benefit in specific patient subsets.
• Lp(a)-lowering therapies are under investigation and show promise as a third pillar of lipid management.

Conclusions:

• Optimizing lipid-lowering therapies targeting apoB particles is crucial for reducing CVD risk.
• Emerging treatments for Lp(a) may significantly impact future CVD prevention strategies.
• A comprehensive approach combining LDL-C, triglyceride, and Lp(a) lowering could potentially eliminate apoB-particle-driven CVD risk.