Laura Alonso-Herranz discusses the study that demonstrated that vascular smooth muscle cells undergo clonal expansion within atherosclerotic plaques and adopt non-canonical features, a work that laid the foundation for subsequent studies on vascular smooth muscle cell plasticity in atherosclerosis.

Apolipoprotein C-III (apoC-III) inhibition represents a major therapeutic advance in the management of severe hypertriglyceridaemia and pancreatitis. The potential role of apoC-III inhibition in preventing atherosclerotic cardiovascular disease will depend on rigorous outcomes data, appropriate patient selection and equitable implementation across healthcare systems. Beyond the lowering of triglyceride levels, meaningful clinical benefits and broad accessibility will determine the long-term success of this therapeutic approach.

In a new study, treatment with self-amplifying RNA contained in lipid nanoparticles to increase the production of atrial natriuretic peptide preserved ventricular function and reduced cardiac fibrosis in mouse and pig models of myocardial infarction.

Elevated plasma concentrations of lipoprotein(a) (Lp(a)) are an important risk factor for several cardiovascular diseases. However, to date, elevated Lp(a) levels have not been directly targeted by clinicians because Lp(a) levels are almost entirely genetically determined and are comparatively resistant to standard lipid-lowering therapies. This unmet medical need might soon be addressed with the advent of potent Lp(a)-lowering therapies.

Angiopoietin-related protein 3 (ANGPTL3)-lowering therapies are an LDL receptor-independent strategy for patients who remain at high cardiovascular risk despite conventional treatment, including those with familial hypercholesterolaemia. By reducing both LDL-cholesterol and triglyceride-rich lipoprotein levels in plasma, ANGPTL3 inhibition addresses a broader atherogenic burden and might offer advantages over apolipoprotein C3 inhibition, with the potential to reshape the management of refractory dyslipidaemias.