Coronary atherosclerotic plaque modification: the present and the future

Area of Science:

• Cardiovascular Medicine
• Pharmacology
• Biomarkers

Background:

• Coronary atherosclerosis involves lipid deposition and inflammation, leading to cardiovascular disease.
• Traditional treatments primarily focus on lipid reduction.
• Emerging therapies aim to modify plaque composition for enhanced stability and prevention of coronary events.

Purpose of the Study:

• To review current and emerging therapies for coronary plaque modification.
• To highlight the role of novel pharmacologic agents and biomarkers in managing atherosclerosis.

Main Methods:

• A comprehensive literature search was conducted across PubMed, Embase, and Scopus until January 2025.
• Key pharmacologic agents and advanced imaging/biomarker techniques were identified and analyzed.

Main Results:

• Proprotein convertase subtilisin/kexin type 9 inhibitors, colchicine, Glucagon-like peptide-1 receptor agonists, and Sodium-glucose cotransporter-2 inhibitors show promise in reducing plaque volume and vulnerability.
• Advances in imaging and biomarkers like lipoprotein(a) and inflammatory markers allow for refined monitoring of plaque changes.

Conclusions:

• Future atherosclerosis management may integrate AI-driven tools and personalized strategies.
• Targeted anti-inflammatory therapies and novel biomarkers like Lp(a) are crucial for precise risk reduction and high-risk plaque stabilization.