Atherosclerosis: Making a U Turn

Annu Rev Med. 2020 Jan 27:71:191-201. doi: 10.1146/annurev-med-042418-011108.

Abstract

The development of potent cholesterol-reducing medications in the last decade of the twentieth century has altered the approach to prevention and treatment of cardiovascular disease (CVD). Initial experience with statins, and more recently with the addition of PCSK9 inhibitors, has proven that human CVD, like that in animal models, can be halted and regressed. Available clinical data show that the lower the achieved level of low-density lipoprotein cholesterol, the greater the regression of disease. Investigative studies are now aimed to understand those factors that both accelerate and impede this healing process. Some of these are likely to be modifiable, and the future of atherosclerotic CVD treatment is likely to be early screening, use of measures to repair atherosclerotic arteries, and prevention of most CVD events.

Keywords: cholesterol; coronary artery disease; myocardial infarction; statin.

Publication types

  • Review

MeSH terms

  • Animals
  • Atherosclerosis / drug therapy
  • Atherosclerosis / metabolism*
  • Atherosclerosis / prevention & control
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / prevention & control
  • Cholesterol / metabolism
  • Cholesterol, HDL / metabolism
  • Cholesterol, LDL / metabolism
  • Chylomicrons / metabolism
  • Computed Tomography Angiography
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Macrophages / metabolism
  • Magnetic Resonance Imaging
  • Mice
  • Mice, Knockout
  • Mice, Knockout, ApoE
  • PCSK9 Inhibitors
  • Plaque, Atherosclerotic / diagnostic imaging
  • Plaque, Atherosclerotic / drug therapy
  • Plaque, Atherosclerotic / metabolism*
  • Plaque, Atherosclerotic / prevention & control
  • Rabbits
  • Rats
  • Receptors, LDL / genetics
  • Receptors, LDL / metabolism
  • Remission Induction
  • Triglycerides / metabolism
  • Ultrasonography, Interventional

Substances

  • Cholesterol, HDL
  • Cholesterol, LDL
  • Chylomicrons
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • PCSK9 Inhibitors
  • Receptors, LDL
  • Triglycerides
  • Cholesterol