Beyond Percutaneous Coronary Intervention - Targeted Molecular Therapies for the Next Era of Coronary Care

Area of Science:

• Cardiovascular Medicine
• Genomics
• Lipid Metabolism

Background:

• Coronary artery disease (CAD) is a leading cause of death globally.
• Current treatments like angioplasty and bypass surgery restore blood flow but don't fully address the underlying molecular causes of atherosclerosis.
• Significant residual risk and bleeding complications persist with existing therapies.

Purpose of the Study:

• To review advances in understanding CAD pathophysiology.
• To explore the potential of a precision-driven
• pharmacological revascularization
• approach.
• To propose a framework for long-term vascular health restoration.

Main Methods:

• Integration of multi-omics data (genomics, proteomics, lipidomics).
• Review of advanced vascular imaging techniques.
• Analysis of emerging targeted therapies including lipid-modifying, metabolic, anti-inflammatory, RNA-based, and gene-editing strategies.

Main Results:

• Novel insights into CAD drivers: dysregulated lipid metabolism, inflammation, thrombosis, and genetics.
• Emerging therapies offer potential for molecular plaque stabilization and inflammation modulation.
• AI and multi-omics are transforming therapeutic strategies.

Conclusions:

• A paradigm shift towards "pharmacological revascularization" is underway.
• Precision medicine, integrating multi-omics and advanced imaging, can guide tailored therapies.
• The goal is to move beyond symptom management to sustained restoration of vascular health and reduced residual risk.