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Cited by 57Lipoproteins and Cardiovascular HealthLipid metabolism and disordersDiabetes, Cardiovascular Risks, and Lipoproteins

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Triglycerides and ASCVD Risk Reduction: Recent Insights and Future Directions

Hussain, Aliza, Ballantyne, Christie M., Saeed, Anum, Virani, Salim S·2020·Current Atherosclerosis Reports
DOI 10.1007/s11883-020-00846-8
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Abstract

Purpose of review This review focuses on recent evidence examining the role triglycerides (TG) and triglyceride-enriched lipoproteins (TGRL) play in atherosclerotic cardiovascular disease (ASCVD). It also provides a succinct overview of current and future TG-lowering therapies for ASCVD risk reduction. Recent findings Epidemiological and Mendelian randomization studies have consistently shown that TGRL are strongly associated with ASCVD. REDUCE-IT demonstrated cardiovascular benefit with icosapent ethyl in high-risk patients with hypertriglyceridemia on statin therapy. Polymorphisms in APOC3 and ANGPTL3 are associated with ASCVD and use of RNA-interfering therapies to target these proteins has shown TG lowering in early phase trials. TG and TGRL are causally associated with ASCVD. Lifestyle modifications and statin therapy can lower TG/TGRL and are considered first-line treatment for hypertriglyceridemia. Icosapent ethyl has been shown to reduce residual ASCVD risk in high-risk patients on maximally tolerated statins. Ongoing clinical trials will better define optimal therapy for patients on statins with residual hypertriglyceridemia.

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  • Even under statin therapy achieving low-density lipoprotein cholesterol control, substantial residual cardiovascular risk persists.

    “Importantly, even under statin therapy achieving low-density lipoprotein cholesterol (LDL-C) control, substantial residual cardiovascular risk persists, largely attributable to elevated triglycerides (TG) and triglyceride-rich lipoprotein (TRL) remnants, including non–HDL-C and apolipoprotein B (apoB) (Watts et al., 2023; Vasas et al., 2024; Hussain et al., 2020; Malick et al., 2023a).”

    From Efficacy and safety of small interfering RNA (siRNA) therapies for hypertriglyceridemia and mixed dyslipidemia: an updated systematic review and meta-analysis (2026) · cites this paper as Hussain et al., 2020

  • The residual cardiovascular risk under statin therapy is largely attributable to elevated triglycerides and triglyceride-rich lipoprotein remnants, including non-HDL-C and apolipoprotein B.

    “Importantly, even under statin therapy achieving low-density lipoprotein cholesterol (LDL-C) control, substantial residual cardiovascular risk persists, largely attributable to elevated triglycerides (TG) and triglyceride-rich lipoprotein (TRL) remnants, including non–HDL-C and apolipoprotein B (apoB) (Watts et al., 2023; Vasas et al., 2024; Hussain et al., 2020; Malick et al., 2023a).”

    From Efficacy and safety of small interfering RNA (siRNA) therapies for hypertriglyceridemia and mixed dyslipidemia: an updated systematic review and meta-analysis (2026) · cites this paper as Hussain et al., 2020

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Metadata

Authors
Hussain, A., Ballantyne, C. M., Saeed, A., & Virani, S. S.
Affiliations
  • Baylor College of Medicine (US)
  • University of Pittsburgh Medical Center (US)
  • Michael E. DeBakey VA Medical Center (US)
Corresponding author
Virani, Salim S
ORCID
Venue
Current Atherosclerosis Reports
Publisher
Springer Science and Business Media LLC
Published
2020-06-03
Volume
22
Issue
7
Pages
25-25
ISSN
  • 1523-3804 (ISSN-L)
  • 1534-6242
DOI
10.1007/s11883-020-00846-8
OpenAlex
W3029160714
Cited by
57
References
74
Citations by year
2026: 5 · 2025: 6 · 2024: 6 · 2023: 13 · 2022: 13 · 2021: 12 · 2020: 2
FWCI
2.27
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Current Atherosclerosis Reports (publishedVersion)
  • PubMed (publishedVersion)
  • eCommons - AKU (Aga Khan University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
triglycerides, atherosclerotic cardiovascular disease, hypertriglyceridemia, icosapent ethyl, statin therapy, residual cardiovascular risk, apolipoprotein C-III, ANGPTL3, RNA interference, Mendelian randomization, lifestyle modification
MeSH terms
Angiopoietin-like Proteins, Angiopoietin-Like Protein 3, Female, Humans, Lipoproteins, Male, Middle Aged, Triglycerides, Eicosapentaenoic Acid, Hypertriglyceridemia, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Polymorphism, Single Nucleotide, RNA Interference, Risk Reduction Behavior, Atherosclerosis, Apolipoprotein C-III, Lipid Regulating Agents

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