Therapies leading to coronary atherosclerosis plaque regression: a scientific statement of the European Association of Preventive Cardiology, the European Association of Cardiovascular Imaging of the ESC, the ESC Working Group on Atherosclerosis and Vascular Biology, and the ESC Working Group on Cardiovascular Pharmacotherapy Part 2-drugs' specific effect on atherosclerosis

Eur J Prev Cardiol. 2025 Nov 6:zwaf654. doi: 10.1093/eurjpc/zwaf654. Online ahead of print.

Abstract

The present is the second part of a scientific statement supported by the European Association of Preventive Cardiology, the European Association of Cardiovascular Imaging of the ESC, the ESC Working Group on Atherosclerosis and Vascular Biology, and the ESC Working Group on Cardiovascular Pharmacotherapy regarding evidence on atherosclerosis regression. This second part is focused on evidence exploring the effect of different therapies, from lipid-lowering to anti-inflammatory drugs, on atherosclerosis progression. Although statins-particularly at higher doses-have the most extensive data supporting their effect on atherosclerosis, mainly resulting in fibro-lipidic plaque volume regression, emerging data suggest that non-statin lipid-lowering drugs and anti-inflammatory therapies may also affect the natural history of atherosclerosis. However, it should be noted that the absolute change in coronary plaque volume is generally limited, underscoring the need for further research on pharmacological intervention targeting atherosclerosis for early identification and treatment of patients at higher risk.

Keywords: Atherosclerosis; Medical Therapy; Primary Prevention.