Despite tremendous advancements in modern medicine, cardiovascular diseases (CVD) are ranked as the primary cause of mortality worldwide. Circulating levels of plasma Low-Density Lipoprotein cholesterol (LDL-C) is an independent risk factor in the development of Atherosclerotic Cardiovascular Disease (ASCVD). Statins have formed the cornerstone of lipid-lowering therapy for several decades and have reduced mortality and morbidity from cardiovascular diseases (CVD).

However, statins have been moderately beneficial in reducing the CVD burden in mild-to-moderate risk patients and cannot be employed to treat dyslipidemia in statin-induced myopathy patients. Emergin evidence also points towards the role of non-High Density Lipoprotein cholesterol (HDL-C) and Apolipoprotein-B (ApoB) in shaping dyslipidemia in patients and their contributory role in CVD disease burden. Leveraging human genetics and large epidemiological studies has enabled the discovery of novel targets in various stages of therapeutic development and clinical practice. Independent of the oxidized LDL, it was proposed that the postprandial increase of the other remnant lipoproteins is a major risk factor for atherosclerosis. Studies have shown most of the postprandial lipoproteins that increase after fat intake are VLDL remnants. The PCSK9 inhibitors have been shown to increase the clearance of the small atherogenic VLDL remnant particles. Apart from PCSK9, which predominantly lowers LDL-C, Bempedoic acid and omega 3 fatty acids have demonstrated efficacy in lowering TGs towards a favorable cardiovascular profile in patients. ANGPTL3, which lowers plasma LDL-C and TGs, provides another option in the existing armamentarium of lipid-lowering agents. Apolipoprotein C-III (ApoC-III) is another novel target in lipoprotein metabolism that reduces triglycerides when inhibited. The antisense oligonucleotide therapy (Volanesorsen) targeting ApoC-III expression at mRNA level has shown a decrease in triglyceride levels in patients with familial chylomicronemia syndrome. Current findings suggest that plasma Lp(a) concentration is associated with the increased risk of cardiovascular events in patients with stable atherosclerotic disease regardless of LDL-C concentration. PCSK9 inhibitors have been shown to decrease Lp(a) levels attenuating the cardiovascular risks.

In this Special Issue, we aim to capture recent developments in lipid-lowering therapies to provide a holistic view of the evolving landscape, which may be of significance to clinicians and researchers alike. Original research and review articles are welcome.

Potential topics include but are not limited to the following:

• Beyond statin therapy
• Earlier is better and the importance of lipid-years
• Pleiotropic effects of other medications such as PCSK 9 and bempedoic acid
• Indications and implications of adding Vascepa (IPEA) on top of statin therapy
• The role of bempedoic acid in current practice
• Development and prospects of inclisiran and the idea of a lipid vaccine
• Lipid-lowering therapy in different subsets of patients with special emphasis on Southeast Asians, Caucasians, and Africans
• New targets for the treatment of hypercholesterolemia