AI Article Synopsis

  • The use of drugs to lower LDL cholesterol (LDL-C) has significantly decreased the risk of heart disease, but some cardiovascular risk remains.
  • Elevated triglycerides (TGs) and TG-rich lipoproteins are linked to increased cardiovascular risk, highlighting the need to address these factors.
  • New treatments targeting apolipoprotein C-III (apoC-III), which plays a crucial role in TG metabolism, show promise in further reducing triglyceride levels and associated heart disease risk.

Article Abstract

The availability of pharmacological approaches able to effectively reduce circulating LDL cholesterol (LDL-C) has led to a substantial reduction in the risk of atherosclerosis-related cardiovascular disease (CVD). However, a residual cardiovascular (CV) risk persists in treated individuals with optimal levels of LDL-C. Additional risk factors beyond LDL-C are involved, and among these, elevated levels of triglycerides (TGs) and TG-rich lipoproteins are causally associated with an increased CV risk. Apolipoprotein C-III (apoC-III) is a key regulator of TG metabolism and hence circulating levels through several mechanisms including the inhibition of lipoprotein lipase activity and alterations in the affinity of apoC-III-containing lipoproteins for both the hepatic receptors involved in their removal and extracellular matrix in the arterial wall. Genetic studies have clarified the role of apoC-III in humans, establishing a causal link with CVD and showing that loss-of-function mutations in the APOC3 gene are associated with reduced TG levels and reduced risk of coronary heart disease. Currently available hypolipidaemic drugs can reduce TG levels, although to a limited extent. Substantial reductions in TG levels can be obtained with new drugs that target specifically apoC-III; these include two antisense oligonucleotides, one small interfering RNA and an antibody.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484501PMC
http://dx.doi.org/10.1093/cvr/cvad177DOI Listing

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