Atherosclerosis: Open Access
Open Access

Atherosclerosis, the process of plaque buildup in the arteries, is a leading cause of cardiovascular diseases, including heart attacks and strokes. Traditionally, treatment options have focused on lifestyle changes, medications, and surgical procedures to manage the condition. However, in recent years, groundbreaking advances in medical research have led to new therapies and approaches for treating atherosclerosis. These innovations aim not only to halt plaque formation but also to target and “break” existing plaque, offering new hope for those at risk of severe cardiovascular events. This article will explore the latest developments in the treatment of atherosclerosis, highlighting their potential to revolutionize care and outcomes [1].

Description

Atherosclerosis is characterized by the accumulation of fatty deposits, cholesterol, and other substances on the inner walls of arteries. Over time, these plaques harden, narrowing the arteries and restricting blood flow. This reduced blood flow can lead to heart attacks, strokes, and peripheral artery disease. While traditional treatments like statins, blood pressure medications, and lifestyle changes have been effective at managing the condition, they often only slow the progression of atherosclerosis or reduce the risk of related complications. Until recently, there was little to no treatment specifically aimed at actively reversing the plaque buildup itself.

However, recent breakthroughs in both pharmacological treatments and non-invasive procedures have provided new strategies for tackling atherosclerosis more directly [2].

New pharmacological therapies

PCSK9 inhibitors: One of the most promising new classes of drugs for atherosclerosis treatment is PCSK9 inhibitors. These medications work by blocking a protein that normally reduces the liver’s ability to clear bad cholesterol (LDL cholesterol) from the bloodstream. By lowering LDL cholesterol levels significantly, these drugs can help prevent further plaque buildup and even reduce the size of existing plaques. While still relatively new, PCSK9 inhibitors such as evolocumab and alirocumab are showing great promise in clinical trials and are already used in patients with high cholesterol or familial hypercholesterolemia.

Inflammation-targeting drugs: Atherosclerosis is also an inflammatory disease, and recent research has focused on developing drugs that specifically target inflammation within arterial plaques. The drug canakinumab, which inhibits interleukin-1β (a protein involved in inflammation), has been shown to reduce the risk of heart attacks and strokes in patients with a history of cardiovascular disease [3]. By addressing inflammation within the plaque, these therapies may help to prevent plaque rupture a major cause of heart attacks.

SGLT2 inhibitors SGLT2 inhibitors, commonly used in the treatment of diabetes, have also shown cardiovascular benefits, particularly in reducing the risk of heart failure and improving artery health. These drugs help reduce blood sugar and improve kidney function, but they also seem to offer protection against the development and progression of atherosclerosis by addressing underlying metabolic conditions [4].

Non-invasive and minimally invasive procedures

In addition to drug-based treatments, there have been significant strides in non-invasive and minimally invasive approaches to treating atherosclerosis and breaking down existing plaques [5].

Atherectomy: Atherectomy is a minimally invasive procedure used to physically remove plaque from the arteries. This can be particularly useful for patients with significant plaque buildup that is restricting blood flow. A catheter with a rotating blade or laser is inserted into the artery, allowing the plaque to be removed or vaporized. This procedure can improve blood flow and reduce the risk of heart attacks or strokes caused by plaque obstruction [6].

Angioplasty and stenting angioplasty, often used in conjunction with stenting, is a more traditional intervention for treating blocked arteries. In this procedure, a balloon is inserted into the narrowed artery and inflated, which pushes the plaque against the artery walls, expanding the vessel and restoring blood flow. A stent (a small mesh tube) is often placed to keep the artery open. This method can help reduce symptoms and prevent the need for more invasive surgery [7].

Gene therapy and nanotechnology: Emerging research in gene therapy and nanotechnology is exploring the possibility of using targeted therapies to break down plaque at the molecular level. Gene therapy could introduce genes that help dissolve cholesterol buildup, while nanotechnology might allow for the precise delivery of drugs directly to plaque sites, minimizing damage to surrounding tissue and improving effectiveness [8]. While still in experimental stages, these approaches offer exciting potential for the future of atherosclerosis treatment.

Conclusion

Atherosclerosis remains a major contributor to cardiovascular disease, but thanks to recent advances in medical research and technology, new treatments are providing more options for patients. From innovative drugs like PCSK9 inhibitors and inflammation-targeting therapies to minimally invasive procedures like atherectomy and angioplasty, the landscape of atherosclerosis treatment is rapidly evolving. While many of these advancements are still in the early stages of development, they hold great promise for breaking down plaque, preventing cardiovascular events, and improving patient outcomes. As research continues and these treatments become more widely available, patients will have access to more effective and targeted therapies, leading to better management and potentially reversing the course of atherosclerosis.

Acknowledgement

None

Conflict of Interest

None

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