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Updated: Jun 4, 2025

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Management of Hypercholesterolemia in Patients with Coronary Artery Disease: A Glimpse into the Future

Alessandro Sciahbasi1, Paola Russo2, Michela Zuccanti2

  • 1Interventional Cardiology, Sandro Pertini Hospital, 00157 Rome, Italy.

Journal of Clinical Medicine
|December 17, 2024
PubMed

Insights

Atherosclerosis causes major global deaths. This review covers current and future therapies targeting low-density lipoprotein cholesterol (LDL-C) and lipoprotein (a) to prevent cardiovascular and cerebrovascular diseases.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Biochemistry

Background:

  • Atherosclerosis remains a leading global cause of mortality.
  • Low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B are key drivers of atherosclerotic plaque formation.
  • Emerging biomarkers like lipoprotein (a) indicate increased risk for atherosclerotic cardiovascular disease (ASCVD).

Purpose of the Study:

  • To review current FDA-approved therapies for lowering LDL-C, assessing their efficacy, safety, and indications.
  • To explore emerging and investigational therapies for LDL-C reduction, including novel agents, gene editing, and immunotherapy.
  • To highlight lipoprotein (a) as a future therapeutic target for ASCVD prevention.

Main Methods:

  • Comprehensive literature review of approved and investigational lipid-lowering therapies.
  • Analysis of clinical trial data on efficacy, tolerability, and safety profiles.
  • Evaluation of the role of biomarkers such as LDL-C and lipoprotein (a) in ASCVD.

Main Results:

  • Multiple drug classes effectively reduce LDL-C through diverse mechanisms.
  • Ongoing research explores novel pharmacological and technological approaches for lipid management.
  • Lipoprotein (a) is emerging as a critical target for future ASCVD therapies.

Conclusions:

  • Current therapies offer significant benefits in managing LDL-C and reducing ASCVD risk.
  • Future therapeutic strategies will likely incorporate novel agents targeting both LDL-C and lipoprotein (a).
  • Advancements in gene editing and immunotherapy hold promise for innovative ASCVD treatments.

Keywords:
Lipoprotein (a)PCSK9ialirocumabbempedoic acidevolocumabezetimibehypercholesterolemiainclisiranstatin

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