Current and Emerging Therapies for Atherosclerosis

Atherosclerotic cardiovascular disease remains a leading cause of morbidity and mortality globally. A large body of evidence supports lifestyle measures for primary prevention, and the addition of a statin and/or antiplatelet agents for those at higher risk, or with established disease. Even with these guideline-driven approaches, many individuals continue to experience recurrent events. A number of agents are now emerging to address this ‘residual risk’ and include potent LDL-lowering molecules, pharmaceutical-grade omega-3 fatty acids, glycaemic agents with pleiotropic properties, targeted anti-inflammatories and antithrombotics. As the evidence base for these agents builds, the ongoing challenge remains to determine which patients are likely to derive the most benefit from each additional, specific therapy; a one-size-fits-all approach is not economical, nor is it patient-centred. This chapter describes the current and established therapies for atherosclerosis, provides a summary of the early evidence behind emerging pharmacological therapies and reinforces the need for ongoing development and application of risk assessment tools to facilitate individualised therapy.