{"title":"Coronary atherosclerotic plaque modification: the present and the future.","authors":"Panagiotis Theofilis, Aggelos Papanikolaou, Paschalis Karakasis, Kyriakos Dimitriadis, Panayotis K Vlachakis, Evangelos Oikonomou, Konstantinos Tsioufis, Dimitris Tousoulis","doi":"10.1080/14779072.2025.2476132","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Coronary atherosclerosis, marked by lipid deposition and inflammation, drives cardiovascular morbidity. Traditional treatments focus on lipid reduction, yet newer therapies target plaque composition, aiming to enhance stability and prevent coronary events.</p><p><strong>Areas covered: </strong>A comprehensive literature search was conducted across PubMed, Embase, and Scopus till January 2025 to identify studies on coronary plaque modification. This review highlights current and emerging therapies for coronary plaque modification. Key pharmacologic agents include Proprotein convertase subtilisin/kexin type 9 inhibitors for lipid management, colchicine for inflammation control, and Glucagon-like peptide-1 receptor agonists, and Sodium-glucose cotransporter-2 inhibitors for metabolic benefits. Clinical trials indicate these agents' roles in reducing plaque volume and vulnerability. Advances in imaging and biomarkers, such as lipoprotein(a) and inflammatory markers, enable refined monitoring of plaque changes over time.</p><p><strong>Expert opinion: </strong>Future management of atherosclerosis may involve personalized strategies, integrating AI-driven predictive tools and biomarkers to assess individual plaque characteristics and optimize therapy. Continued exploration of targeted anti-inflammatory therapies and novel biomarkers like Lp(a) could enhance outcomes, offering a more precise approach to reducing cardiovascular risk and stabilizing high-risk plaques.</p>","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"65-71"},"PeriodicalIF":1.8000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Cardiovascular Therapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/14779072.2025.2476132","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/5 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Coronary atherosclerosis, marked by lipid deposition and inflammation, drives cardiovascular morbidity. Traditional treatments focus on lipid reduction, yet newer therapies target plaque composition, aiming to enhance stability and prevent coronary events.
Areas covered: A comprehensive literature search was conducted across PubMed, Embase, and Scopus till January 2025 to identify studies on coronary plaque modification. This review highlights current and emerging therapies for coronary plaque modification. Key pharmacologic agents include Proprotein convertase subtilisin/kexin type 9 inhibitors for lipid management, colchicine for inflammation control, and Glucagon-like peptide-1 receptor agonists, and Sodium-glucose cotransporter-2 inhibitors for metabolic benefits. Clinical trials indicate these agents' roles in reducing plaque volume and vulnerability. Advances in imaging and biomarkers, such as lipoprotein(a) and inflammatory markers, enable refined monitoring of plaque changes over time.
Expert opinion: Future management of atherosclerosis may involve personalized strategies, integrating AI-driven predictive tools and biomarkers to assess individual plaque characteristics and optimize therapy. Continued exploration of targeted anti-inflammatory therapies and novel biomarkers like Lp(a) could enhance outcomes, offering a more precise approach to reducing cardiovascular risk and stabilizing high-risk plaques.
以脂质沉积和炎症为标志的冠状动脉粥样硬化是心血管疾病的主要诱因。传统的治疗方法侧重于降低脂质，而新的治疗方法针对斑块组成，旨在增强稳定性和预防冠状动脉事件。覆盖领域：截至2025年1月，在PubMed、Embase和Scopus上进行了全面的文献检索，以确定冠状动脉斑块修饰的研究。本文综述了当前和新兴的冠状动脉斑块修饰疗法。关键的药理学药物包括用于脂质管理的Proprotein conversion ase subtilisin/kexin type 9抑制剂，用于炎症控制的秋水仙碱，以及用于代谢益处的胰高血糖素样肽-1受体激动剂和钠-葡萄糖共转运蛋白-2抑制剂。临床试验表明这些药物在减少斑块体积和易损性方面的作用。成像和生物标志物的进步，如脂蛋白(a)和炎症标志物，可以精确监测斑块随时间的变化。专家意见：未来动脉粥样硬化的管理可能涉及个性化策略，整合人工智能驱动的预测工具和生物标志物，以评估个体斑块特征并优化治疗。持续探索靶向抗炎疗法和Lp(a)等新型生物标志物可以提高疗效，为降低心血管风险和稳定高风险斑块提供更精确的方法。
期刊介绍：
Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.
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