Luz C. Zárate-Correa, Sección de Cardiología, Universidad del Valle, Cardiodec y Clínica Cardio Neurovascular DIME, Cali, Colombia
Ángel A. García-Peña, Unidad de Cardiología, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
Pablo Corral, Departamento de Farmacología e Investigación, Universidad Fasta, Mar del Plata, Argentina
Kausik Ray, Escuela de Salud Pública, Imperial College London, Londres, Reino Unido
Introduction: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality worldwide, associated with the subendothelial deposition of ApoB-rich particles such as LDL cholesterol (LDL-c). Multiple clinical studies highlight the importance of reducing LDL-c and ApoB levels to prevent and manage atherosclerosis. This requires addressing modifiable risk factors and utilizing pharmacological therapies such as statins, ezetimibe, PCSK9 monoclonal antibodies, inclisiran, and bempedoic acid. Objective: to review the available evidence on pharmacological therapies and their impact on LDL-c reduction, cardiovascular event prevention, with a focus on adherence and long-term implementation. Method: review of scientific literature was conducted, focusing on the effects of lipid-lowering therapies and evaluating their potential impact on cardiovascular event prevention and public health relevance. Results: the evaluated therapies reduce the risk of cardio-vascular events, with long-term adherence being a key factor. Inclisiran, a small interfering RNA therapy, sustainably lowers LDL-c, and simulation studies demonstrate a significant impact in preventing thousands of cardiovascular events over ten years, with improved adherence. Conclusion: Pharmacological therapies, such as inclisiran, represent a significant advance in the management of ASCVD. Their large-scale implementation, combined with lifestyle modifications, can substantially mitigate the burden of cardiovascular disease.
Keywords: Atherosclerotic cardiovascular disease. LDL cholesterol. Atherosclerosis. Cardiovascular mortality. Statins. Ezetimibe. Monoclonal antibodies against PCSK9. Inclisiran.
