The Effect of Lipid-Lowering Therapy on Coronary Artery Plaque in East Asia Population (JACC Asia August 2025)-Article: The Effect of Lipid-Lowering Therapy on Coronary Artery Plaque in East Asia Population

Article: The Effect of Lipid-Lowering Therapy on Coronary Artery Plaque in East Asia Population

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The study examines the effects of lipid-lowering therapy (LLT) on coronary atherosclerotic plaque in East Asian populations. Utilizing a systematic literature review and meta-analysis, the research compiles data from 48 studies involving 4,147 patients. Key findings indicate that lower levels of low-density lipoprotein cholesterol (LDL-C) are associated with significant coronary plaque regression and stabilization. Specifically, LDL-C levels at or below 55 mg/dL correlate with the greatest decrease in percent atheroma volume (PAV) and increased fibrous cap thickness (FCT), revealing the advantageous effects of LLT in reducing atherosclerotic cardiovascular disease (ASCVD) risk.<br /><br />The analysis suggests that LLTs such as high-intensity statins or combinations with ezetimibe or PCSK9 inhibitors provide maximum benefits. Furthermore, the study finds that intensive LLT aimed at lowering LDL-C to 55 mg/dL is particularly beneficial, supporting current guidelines that recommend aggressive LDL-C reduction in ASCVD management. The focus on East Asian individuals highlights racial and genetic variances, suggesting tailored treatment strategies to enhance cardiovascular outcomes. The study acknowledges limitations such as diverse study designs and heterogeneity among participants but maintains the overarching benefit of LLT for plaque reduction and improved cardiovascular prognosis.<br /><br />In conclusion, this meta-analysis underscores the importance of aggressive LDL-C management in East Asian populations for ASCVD prevention, aligning with existing guidelines that recommend intensive lipid-lowering strategies and emphasizing the need for personalized treatment approaches based on regional and genetic particularities.

Keywords

lipid-lowering therapy

coronary atherosclerotic plaque

East Asian populations

low-density lipoprotein cholesterol

atherosclerotic cardiovascular disease

statins

ezetimibe

PCSK9 inhibitors

personalized treatment

meta-analysis