Triglycerides and ASCVD Risk Reduction: Recent Insights and Future Directions

Aliza Hussain, Christie M. Ballantyne, Anum Saeed, Salim S. Virani

Research output: Contribution to journalReview articlepeer-review

37 Citations (Scopus)

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. Summary: 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.

Original languageEnglish
Article number25
JournalCurrent Atherosclerosis Reports
Volume22
Issue number7
DOIs
Publication statusPublished - 1 Jul 2020
Externally publishedYes

Keywords

  • ASCVD
  • Angiopoietin 3
  • Apolipoprotein C3
  • Omega-3 fatty acids
  • Triglyceride-rich lipoproteins
  • Triglycerides

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