Role of Lipid-Lowering and Anti-Inflammatory Therapies on Plaque Stabilization

• Published in: Journal of clinical medicine Vol. 13; no. 11; p. 3096
• Main Authors: Bryniarski, Krzysztof L, den Dekker, Wijnand, Legutko, Jacek, Gasior, Pawel, Tahon, Jeroen, Diletti, Roberto, Wilschut, Jeroen M, Nuis, Rutger-Jan, Daemen, Joost, Kleczynski, Pawel, Van Mieghem, Nicolas M, Jang, Ik-Kyung
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 01.06.2024; MDPI
• Subjects: Atherosclerosis; Cardiovascular disease; Care and treatment; Cholesterol; Clinical medicine; Clinical trials; coronary artery disease; Diagnosis; Health aspects; Heart attacks; Inflammation; lipid-lowering therapy; Lipids; Medical imaging; Myocardial ischemia; plaque vulnerability; Review; Smooth muscle; Statins; Ultrasonic imaging; Poland
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm13113096

Atherosclerosis is the predominant underlying etiopathology of coronary artery disease. Changes in plaque phenotype from stable to high risk may spur future major adverse cardiac events (MACE). Different pharmacological therapies have been implemented to mitigate this risk. Over the last two decades, intravascular imaging modalities have emerged in clinical studies to clarify how these therapies may affect the composition and burden of coronary plaques. Lipid-lowering agents, such as statins, ezetimibe, and proprotein convertase subtilisin/kexin type 9 inhibitors, were shown not only to reduce low-density lipoprotein levels and MACE but also to directly affect features of coronary plaque vulnerability. Studies have demonstrated that lipid-lowering therapy reduces the percentage of atheroma volume and number of macrophages and increases fibrous cap thickness. Future studies should answer the question of whether pharmacological plaque stabilization may be sufficient to mitigate the risk of MACE for selected groups of patients with atherosclerotic coronary disease.