Background:
Statins have long been the cornerstone of lipid-lowering therapy for the prevention and management of atherosclerotic
cardiovascular disease (ASCVD). Despite their proven efficacy, a significant proportion of patients remain at high residual
cardiovascular risk due to statin intolerance, inadequate LDL-C lowering, or other lipid-related abnormalities.
Objective:
This review aims to provide an up-to-date overview of emerging lipid-lowering therapies that extend beyond statins, focusing on
their mechanisms of action, clinical efficacy, and integration into contemporary lipid management.
Methods:
We analyzed data from key randomized controlled trials, consensus statements, and recent clinical guidelines to evaluate the
efficacy, safety, and clinical roles of novel therapies including PCSK9 inhibitors, inclisiran, bempedoic acid, ezetimibe, antisense
and siRNA-based agents targeting lipoprotein(a) and ApoC-III, and triglyceride-lowering interventions.
Results:
New agents demonstrate substantial LDL-C and triglyceride reductions, improved patient adherence, and favorable
cardiovascular outcomes in high-risk populations. Therapies targeting lipoprotein(a), ApoC-III, and ANGPTL3 represent
promising tools for future risk reduction. Combination and personalized approaches tailored to individual lipid profiles and
genetic risk factors are now recommended in updated guidelines.
Conclusion:
Emerging lipid-lowering therapies offer significant promise in reducing residual ASCVD risk, particularly when integrated into a
comprehensive, personalized treatment strategy. The evolving therapeutic landscape heralds a shift toward precision lipidology
and underscores the need for broader access and clinician education to optimize patient outcomes.