Abstract
Cardiovascular disease (CAD) is the main cause of morbidity and deaths in the western world. The development of atherosclerosis underlying CAD development begins early in human life. There are numerous genetic and environmental risk factors accelerating its progression which then leads to the occurrence of acute events. Despite considerable progress in determining risk factors, there is still a lot of work ahead since identified determinants are responsible only for a part of overall CAD risk. Current therapies are insufficient to successfully reduce the risk of atherosclerosis development. Therefore, there is a need for effective preventive measures of clinical manifestations of atherosclerosis since the currently available drugs cannot prevent the occurrence of even 70% of clinical events. The shift of the target from lipid metabolism has opened the door to many new therapeutic targets. Currently, the majority of known targets for anti-atherosclerotic drugs focus also on inflammation (a common mediator of many risk factors), mechanisms of innate and adaptive immunity in atherosclerosis, molecule scavengers, etc. The therapeutic potential of cyclodextrins, protein kinase inhibitors, colchicine, inhibitors of p38 mitogen-activated protein kinase (MAPK), lipid dicarbonyl scavengers, a monoclonal antibody targeting interleukin-1β, and P-selectin inhibitors is still not fully confirmed and requires confirmation in large clinical trials. The preliminary results look promising.
Highlights
Cardiovascular disease (CAD) is a serious health problem and the main cause of death and morbidity in the western world [1,2]
This study demonstrated multiple antiatherogenic therapeutic cholesterolemia (FH) contained elevated levels of MDA adducts vs control subjects, effects translating into significantly reduced atherosclerosis development related to the while its2-HOBA
Considering all the obtained effects and the evidence indicating that monoclonal antibodies that target proteintargeting and interleuproprotein convertase subtilisin–kexin type 9 (PCSK9) reduce the incidence of major adverse cardiovascular events when used as an add-on therapy to statins, it seems plausible that inclisiran may contribute to the lowering of the incidence of cardiovascular disease in high-risk patients [57]
Summary
Cardiovascular disease (CAD) is a serious health problem and the main cause of death and morbidity in the western world [1,2]. The understanding of causes and mechanisms of the disease (here CAD) would allow the identification of risk factors and innovative drug targets, the design of tailored treatments, the prediction of clinical outcomes, and the establishment of preventive strategies [5]. Current therapeutic interventions are aimed at slowing down the progression of atherosclerosis and concentrate mostly on decreasing cholesterol levels [7] Such treatment turned out not to be effective for all patients [12]. Some cytokines have been found to modulate the progression of atherosclerosis and, they were identified as potential therapeutic targets [18,19] Various antigens, such as bacterial and viral antigens, as well as self-antigens, e.g., heat shock protein 60 (HSP60), have been suggested to be involved in the initiation of immune responses that stimulate atherosclerosis [15,20]. This review will focus on emerging therapies and novel use of old drugs in the treatment of cardiovascular diseases
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