Chapter 10. Emerging Opportunities in the Treatment of Atherosclerosis

Publisher Summary Atherosclerosis, characterized by the deposition of lipids and fibrotic material in the arterial wall, is recognized as the leading contributor to cardiovascular disease, such as coronary heart disease (CHD). High levels of low density lipoprotein cholesterol (LDL-C), is a well established risk factor for CHD. Significant effort and progress have been made in recent years in the development of agents that lower LDL-C. Clinical trials with HMG-CoA reductase inhibitors (statins), the most commonly prescribed LDL-C lowering therapy. It has demonstrated a decrease in cardiovascular morbidity and mortality in patients with and without pre-existing CHD. It is generally accepted that the low levels of high density lipoprotein cholesterol (HDL-C) and high levels of triglycerides are also important risk factors, resulting in a growing emphasis to treat low HDL-C and high triglycerides. In addition to the conventional lipid therapies, modification of the underlying mechanisms of plaque formation and stabilization within the arterial wall presents an alternative potential therapy for the treatment of atherosclerosis. This chapter discusses some of the recent developments in LDL-C lowering and HDL-C elevation approaches, as well as approaches targeting the atherosclerotic plaque, focusing primarily on the programs in preclinical or early clinical development.