Cardiovascular Prevention and Pharmacotherapy

Review Articles

Apolipoprotein CIII (APOC3) and angiopoietin-like protein 3 (ANGPTL3) inhibitors: current evidence and future directions: Jee Hee Yoo; Cardiovasc Prev Pharmacother. 2025;7(4):146-154. Published online October 23, 2025; DOI: https://doi.org/10.36011/cpp.2025.7.e19

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Abstract PDF: Familial chylomicronemia syndrome (FCS) and homozygous familial hypercholesterolemia (HoFH) are rare genetic disorders characterized by profound dyslipidemia and high residual cardiovascular risk, for which conventional therapies have demonstrated limited efficacy. Recent advances in antisense oligonucleotide and small interfering RNA (siRNA)–based therapies targeting apolipoprotein CIII (APOC3) and angiopoietin-like protein 3 (ANGPTL3) have introduced promising treatment options. APOC3 inhibitors such as volanesorsen and olezarsen have been shown to markedly reduce triglyceride (TG) levels and lower the incidence of pancreatitis in individuals with FCS and severe hypertriglyceridemia. siRNA-based plozasiran has produced durable TG-lowering effects with favorable tolerability, although mild hyperglycemia has been observed in individuals with diabetes. In parallel, ANGPTL3 inhibition through monoclonal antibodies (e.g., evinacumab) or RNA inhibitor-based agents (e.g., zodasiran) enables low-density lipoprotein (LDL) receptor–independent LDL cholesterol reduction, offering a valuable therapeutic option for people with HoFH. These agents may help mitigate residual atherosclerotic cardiovascular disease risk in populations insufficiently managed by traditional lipid-lowering therapies. Nevertheless, cardiovascular outcome trials remain unavailable, and long-term benefits have yet to be established. Furthermore, high costs and restricted access pose additional barriers, especially in countries such as Korea, where regulatory approval and importation are pending. To maximize their global impact, cost-effective strategies and equitable access must be prioritized.

Lipid variability in patients with diabetes mellitus: Jeongmin Lee, Seung-Hwan Lee; Cardiovasc Prev Pharmacother. 2023;5(4):126-133. Published online October 25, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e18

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Diabetic dyslipidemia is characterized by hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), elevated low-density lipoprotein cholesterol (LDL-C), and the predominance of small dense LDL particles caused by insulin resistance in patients with type 2 diabetes mellitus (DM) or insulin deficiency in patients with type 1 DM. Dyslipidemia is a major risk factor for atherosclerotic cardiovascular disease in individuals with DM, and lowering lipid levels can reduce the associated morbidity and mortality. The current guidelines for dyslipidemia management recommend an LDL-C goal lower than 55 to 100 mg/dL, depending on the underlying risk factors. However, greater visit-to-visit variability in cholesterol levels might be an independent predictor of major adverse cardiovascular events, high incidence of atrial fibrillation, poor renal outcomes, and cognitive dysfunction in patients with DM. This review focuses on the clinical implications of lipid variability in patients with DM.

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Visit-to-visit lipid variability and adverse kidney events in real-world type 2 diabetes patients
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Antidiabetic and Toxicological Evaluation of Ehretia asperula Leaf Extract in Diabetic Mice
Yen D. H. Nguyen, Tran Chi Linh, Nguyen Trong Tuan, Luu Thai Danh, Dai Thi Xuan Trang
Chemistry & Biodiversity.2025;[Epub] CrossRef
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Public Health, Economy and Management in Medicine.2024; (5(102)): 59. CrossRef

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