New Approaches to Lipoproteins for the Prevention of Cardiovascular Events

Area of Science:

• Cardiology
• Lipidology
• Preventive Medicine

Background:

• Atherosclerotic cardiovascular disease (ASCVD) is a major cause of death globally.
• Elevated low-density lipoprotein cholesterol (LDL-C) is a key driver of cardiovascular events.
• A gap exists between recommended LDL-C targets and actual clinical practice.

Purpose of the Study:

• To review current care gaps in lipid-lowering therapy (LLT).
• To explore innovative strategies for lipoprotein management beyond LDL-C.
• To discuss the potential of new therapies and risk stratification tools.

Main Methods:

• Literature review of current guidelines and emerging research.
• Analysis of combination therapies (e.g., statins with ezetimibe, PCSK9 inhibitors).
• Evaluation of novel lipid-modifying agents (e.g., bempedoic acid, inclisiran, Lp(a) lowering drugs).
• Discussion of polygenic risk scores for guiding LLT and lifestyle changes.

Main Results:

• Combination therapies demonstrate enhanced LDL-C reduction and improved outcomes in high-risk patients.
• New agents like bempedoic acid, inclisiran, and Lp(a) inhibitors show promise for cardiovascular risk reduction.
• Polygenic risk scores may help personalize LLT and lifestyle interventions, though implementation challenges exist.

Conclusions:

• Optimizing lipoprotein management requires innovative approaches beyond standard LDL-C lowering.
• Combination therapies and novel agents are crucial for high-risk ASCVD patients.
• Personalized strategies, potentially guided by polygenic risk scores, are key to improving ASCVD prevention outcomes.