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

Author:

Bryniarski Krzysztof L.12,den Dekker Wijnand1,Legutko Jacek2,Gasior Pawel3ORCID,Tahon Jeroen14,Diletti Roberto1,Wilschut Jeroen M.1,Nuis Rutger-Jan1,Daemen Joost1,Kleczynski Pawel2ORCID,Van Mieghem Nicolas M.1,Jang Ik-Kyung5ORCID

Affiliation:

1. Department of interventional Cardiology, Thoraxcenter, Cardiovascular Institute, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands

2. Department of Interventional Cardiology, Jagiellonian University Medical College, Institute of Cardiology, St. John Paul II Hospital, 31-202 Krakow, Poland

3. Division of Cardiology and Structural Heart Diseases, Medical University of Silesia in Katowice, 40-055 Katowice, Poland

4. Department of Interventional Cardiology, Imelda Hospital, 2820 Bonheiden, Belgium

5. Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA

Abstract

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.

Publisher

MDPI AG

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. The clinical relevance of the reversal of coronary atherosclerotic plaque;European Journal of Internal Medicine;2024-08

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