Triglycerides and ASCVD Risk Reduction: Recent Insights and Future Directions.

Abstract

PURPOSE OF REVIEW:

This review focuses on recent evidence examining the role triglycerides (TG) and triglyceride-enriched lipoproteins (TGRL) play in atherosclerotic cardiovascular disease (ASCVD). It also provides a succinct overview of current and future TG-lowering therapies for ASCVD risk reduction.

RECENT FINDINGS:

Epidemiological and Mendelian randomization studies have consistently shown that TGRL are strongly associated with ASCVD. REDUCE-IT demonstrated cardiovascular benefit with icosapent ethyl in high-risk patients with hypertriglyceridemia on statin therapy. Polymorphisms in APOC3 and ANGPTL3 are associated with ASCVD and use of RNA-interfering therapies to target these proteins has shown TG lowering in early phase trials. TG and TGRL are causally associated with ASCVD. Lifestyle modifications and statin therapy can lower TG/TGRL and are considered first-line treatment for hypertriglyceridemia. Icosapent ethyl has been shown to reduce residual ASCVD risk in high-risk patients on maximally tolerated statins. Ongoing clinical trials will better define optimal therapy for patients on statins with residual hypertriglyceridemia.

• Authors: Aliza Hussain, Christie M Ballantyne, Anum Saeed, Salim S Virani
• Journal: Current atherosclerosis reports (Curr Atheroscler Rep) Vol. 22 Issue 7 Pg. 25 (06 03 2020) ISSN: 1534-6242 [Electronic] United States
• PMID: 32494924 (Publication Type: Journal Article, Review)

Chemical References

• ANGPTL3 protein, human
• APOC3 protein, human
• Angiopoietin-Like Protein 3
• Angiopoietin-like Proteins
• Apolipoprotein C-III
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Lipid Regulating Agents
• Lipoproteins
• Triglycerides
• lipoprotein triglyceride
• eicosapentaenoic acid ethyl ester
• Eicosapentaenoic Acid

Topics

• Angiopoietin-Like Protein 3
• Angiopoietin-like Proteins (genetics)
• Apolipoprotein C-III (genetics)
• Atherosclerosis (drug therapy, etiology, metabolism)
• Eicosapentaenoic Acid (analogs & derivatives, therapeutic use)
• Female
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use)
• Hypertriglyceridemia (complications, drug therapy)
• Lipid Regulating Agents (therapeutic use)
• Lipoproteins (metabolism)
• Male
• Middle Aged
• Polymorphism, Single Nucleotide
• RNA Interference
• Risk Reduction Behavior
• Triglycerides (metabolism)