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14-11-2024 | Coronary Heart Disease | Review Free for a limited time

The Emerging Potential of Apolipoprotein C-III Inhibition for ASCVD Prevention: A State-of-the-Art Review

Authors: Samuel D. Maidman, Robert A. Hegele, Robert S. Rosenson

Published in: Current Atherosclerosis Reports | Issue 1/2024

Abstract

Purpose of Review

Multiple agents are being developed that inhibit apolipoprotein (apo) C-III. This state-of-the-art review examines their potential for atherosclerotic cardiovascular disease (ASCVD) risk reduction.

Recent Findings

Apo C-III, an apolipoprotein on the surface of triglyceride-rich lipoproteins (TRLs), impairs clearance of TRLs through both lipoprotein lipase dependent and independent pathways, thereby resulting in increased concentrations of triglycerides. Apo C-III has also been shown to have pro-atherogenic effects when bound to high-density lipoprotein (HDL) particles. Classical and genetic epidemiology studies provide support for the concept that apo C-III is associated with an increased risk of ASCVD events.

Summary

Drug efficacy of agents that silence APOC3 mRNA has been studied in populations with varying hypertriglyceridemia severity, including those with familial chylomicronemia syndrome, multifactorial chylomicronemia syndrome/severe hypertriglyceridemia, and mixed hyperlipidemia. Randomized controlled trials have reported significant reductions in TG and non-HDL cholesterol levels among these patients treated with APOC3 inhibitors. Upcoming clinical outcomes trials seek to establish a role for APOC3 inhibitors to reduce risk of ASCVD.

Collaborators GBDCD. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the global burden of Disease Study 2021. Lancet. 2024;403(10440):2100–32. https://doi.org/10.1016/S0140-6736(24)00367-2.CrossRef

Writing C, Lloyd-Jones DM, Morris PB, Ballantyne CM, Birtcher KK, Covington AM, et al. 2022 ACC Expert Consensus decision pathway on the role of nonstatin therapies for LDL-Cholesterol lowering in the management of atherosclerotic Cardiovascular Disease Risk: a report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2022;80(14):1366–418. https://doi.org/10.1016/j.jacc.2022.07.006.CrossRef

Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, et al. 2019 ACC/AHA Guideline on the primary Prevention of Cardiovascular Disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice guidelines. Circulation. 2019;140(11):e563–95. https://doi.org/10.1161/CIR.0000000000000677.CrossRefPubMedPubMedCentral

Ginsberg HN, Packard CJ, Chapman MJ, Boren J, Aguilar-Salinas CA, Averna M, et al. Triglyceride-rich lipoproteins and their remnants: metabolic insights, role in atherosclerotic cardiovascular disease, and emerging therapeutic strategies-a consensus statement from the European Atherosclerosis Society. Eur Heart J. 2021;42(47):4791–806. https://doi.org/10.1093/eurheartj/ehab551.CrossRefPubMedPubMedCentral

Nordestgaard BG. Triglyceride-Rich lipoproteins and Atherosclerotic Cardiovascular Disease: New insights from Epidemiology, Genetics, and Biology. Circ Res. 2016;118(4):547–63. https://doi.org/10.1161/CIRCRESAHA.115.306249.CrossRefPubMed

Quispe R, Martin SS, Michos ED, Lamba I, Blumenthal RS, Saeed A, et al. Remnant cholesterol predicts cardiovascular disease beyond LDL and ApoB: a primary prevention study. Eur Heart J. 2021;42(42):4324–32. https://doi.org/10.1093/eurheartj/ehab432.CrossRefPubMedPubMedCentral

Nicholls SJ, Lincoff AM, Garcia M, Bash D, Ballantyne CM, Barter PJ, et al. Effect of high-dose Omega-3 fatty acids vs corn oil on major adverse Cardiovascular events in patients at High Cardiovascular Risk: the STRENGTH Randomized Clinical Trial. JAMA. 2020;324(22):2268–80. https://doi.org/10.1001/jama.2020.22258.CrossRefPubMedPubMedCentral

Witztum JL, Gaudet D, Freedman SD, Alexander VJ, Digenio A, Williams KR, et al. Volanesorsen and triglyceride levels in familial chylomicronemia syndrome. N Engl J Med. 2019;381(6):531–42. https://doi.org/10.1056/NEJMoa1715944.CrossRefPubMed

Malick WA, Do R, Rosenson RS. Severe hypertriglyceridemia: existing and emerging therapies. Pharmacol Ther. 2023;251:108544. https://doi.org/10.1016/j.pharmthera.2023.108544.CrossRefPubMed

10.

Shaik A, Rosenson RS. Genetics of Triglyceride-Rich Lipoproteins Guide Identification of Pharmacotherapy for Cardiovascular Risk reduction. Cardiovasc Drugs Ther. 2021;35(3):677–90. https://doi.org/10.1007/s10557-021-07168-0.CrossRefPubMed

11.

Rosenson RS, Shaik A, Song W. New therapies for lowering triglyceride-rich lipoproteins: JACC Focus Seminar 3/4. J Am Coll Cardiol. 2021;78(18):1817–30. https://doi.org/10.1016/j.jacc.2021.08.051.CrossRefPubMedPubMedCentral

12.

Mehta A, Shapiro MD. Apolipoproteins in vascular biology and atherosclerotic disease. Nat Rev Cardiol. 2022;19(3):168–79. https://doi.org/10.1038/s41569-021-00613-5.CrossRefPubMed

13.

Ooi EM, Barrett PH, Chan DC, Watts GF. Apolipoprotein C-III: understanding an emerging cardiovascular risk factor. Clin Sci (Lond). 2008;114(10):611–24. https://doi.org/10.1042/CS20070308.CrossRefPubMed

14.

Jong MC, Hofker MH, Havekes LM. Role of ApoCs in lipoprotein metabolism: functional differences between ApoC1, ApoC2, and ApoC3. Arterioscler Thromb Vasc Biol. 1999;19(3):472–84. https://doi.org/10.1161/01.atv.19.3.472.CrossRefPubMed

15.

Hertz R, Bishara-Shieban J, Bar-Tana J. Mode of action of peroxisome proliferators as hypolipidemic drugs. Suppression of apolipoprotein C-III. J Biol Chem. 1995;270(22):13470–5. https://doi.org/10.1074/jbc.270.22.13470.CrossRefPubMed

16.

Giammanco A, Spina R, Cefalu AB, Averna M. APOC-III: a gatekeeper in Controlling triglyceride metabolism. Curr Atheroscler Rep. 2023;25(3):67–76. https://doi.org/10.1007/s11883-023-01080-8.CrossRefPubMedPubMedCentral

17.

Brown WV, Baginsky ML. Inhibition of lipoprotein lipase by an apoprotein of human very low density lipoprotein. Biochem Biophys Res Commun. 1972;46(2):375–82. https://doi.org/10.1016/s0006-291x(72)80149-9.CrossRefPubMed

18.

Kinnunen PK, Ehnolm C. Effect of serum and C-apoproteins from very low density lipoproteins on human postheparin plasma hepatic lipase. FEBS Lett. 1976;65(3):354–7. https://doi.org/10.1016/0014-5793(76)80145-7.CrossRefPubMed

19.

Ginsberg HN, Goldberg IJ. Broadening the scope of Dyslipidemia Therapy by Targeting APOC3 (apolipoprotein C3) and ANGPTL3 (Angiopoietin-Like protein 3). Arterioscler Thromb Vasc Biol. 2023;43(3):388–98. https://doi.org/10.1161/ATVBAHA.122.317966.CrossRefPubMed

20.

Aalto-Setala K, Fisher EA, Chen X, Chajek-Shaul T, Hayek T, Zechner R, et al. Mechanism of hypertriglyceridemia in human apolipoprotein (apo) CIII transgenic mice. Diminished very low density lipoprotein fractional catabolic rate associated with increased apo CIII and reduced apo E on the particles. J Clin Invest. 1992;90(5):1889–900. https://doi.org/10.1172/JCI116066.CrossRefPubMedPubMedCentral

21.

Ference BA, Ginsberg HN, Graham I, Ray KK, Packard CJ, Bruckert E, et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel. Eur Heart J. 2017;38(32):2459–72. https://doi.org/10.1093/eurheartj/ehx144.CrossRefPubMedPubMedCentral

22.

Goldstein JL, Brown MS. A century of cholesterol and coronaries: from plaques to genes to statins. Cell. 2015;161(1):161–72. https://doi.org/10.1016/j.cell.2015.01.036.CrossRefPubMedPubMedCentral

23.

Cromwell WC, Otvos JD, Keyes MJ, Pencina MJ, Sullivan L, Vasan RS, et al. LDL particle number and risk of Future Cardiovascular Disease in the Framingham offspring study - implications for LDL management. J Clin Lipidol. 2007;1(6):583–92. https://doi.org/10.1016/j.jacl.2007.10.001.CrossRefPubMedPubMedCentral

24.

Grundy SM, Small LDL. Atherogenic dyslipidemia, and the metabolic syndrome. Circulation. 1997;95(1):1–4. https://doi.org/10.1161/01.cir.95.1.1.CrossRefPubMed

25.

Johannesen CDL, Langsted A, Nordestgaard BG, Mortensen MB. Excess apolipoprotein B and Cardiovascular Risk in women and men. J Am Coll Cardiol. 2024;83(23):2262–73. https://doi.org/10.1016/j.jacc.2024.03.423.CrossRefPubMed

26.

Glavinovic T, Thanassoulis G, de Graaf J, Couture P, Hegele RA, Sniderman AD. Physiological bases for the superiority of apolipoprotein B over low-density lipoprotein cholesterol and Non-high-density Lipoprotein Cholesterol as a marker of Cardiovascular Risk. J Am Heart Assoc. 2022;11(20):e025858. https://doi.org/10.1161/JAHA.122.025858.CrossRefPubMedPubMedCentral

27.

Avogaro P, Bon GB, Cazzolato G, Quinci GB. Are apolipoproteins better discriminators than lipids for atherosclerosis? Lancet. 1979;1(8122):901–3. https://doi.org/10.1016/s0140-6736(79)91375-8.CrossRefPubMed

28.

Sniderman A, Shapiro S, Marpole D, Skinner B, Teng B, Kwiterovich PO. Jr. Association of coronary atherosclerosis with hyperapobetalipoproteinemia [increased protein but normal cholesterol levels in human plasma low density (beta) lipoproteins]. Proc Natl Acad Sci U S A. 1980;77(1):604–8. https://doi.org/10.1073/pnas.77.1.604.CrossRefPubMedPubMedCentral

29.

Marston NA, Giugliano RP, Melloni GEM, Park JG, Morrill V, Blazing MA, et al. Association of Apolipoprotein B-Containing Lipoproteins and risk of myocardial infarction in individuals with and without atherosclerosis: distinguishing between particle concentration, type, and content. JAMA Cardiol. 2022;7(3):250–6. https://doi.org/10.1001/jamacardio.2021.5083.CrossRefPubMed

30.

Ference BA, Kastelein JJP, Ray KK, Ginsberg HN, Chapman MJ, Packard CJ, et al. Association of Triglyceride-Lowering LPL variants and LDL-C-Lowering LDLR variants with risk of Coronary Heart Disease. JAMA. 2019;321(4):364–73. https://doi.org/10.1001/jama.2018.20045.CrossRefPubMedPubMedCentral

31.

Hagstrom E, Steg PG, Szarek M, Bhatt DL, Bittner VA, Danchin N, et al. Apolipoprotein B, residual Cardiovascular Risk after Acute Coronary Syndrome, and effects of Alirocumab. Circulation. 2022;146(9):657–72. https://doi.org/10.1161/CIRCULATIONAHA.121.057807.CrossRefPubMedPubMedCentral

32.

Alaupovic P, Mack WJ, Knight-Gibson C, Hodis HN. The role of triglyceride-rich lipoprotein families in the progression of atherosclerotic lesions as determined by sequential coronary angiography from a controlled clinical trial. Arterioscler Thromb Vasc Biol. 1997;17(4):715–22. https://doi.org/10.1161/01.atv.17.4.715.CrossRefPubMed

33.

Bjornson E, Adiels M, Taskinen MR, Burgess S, Rawshani A, Boren J, Packard CJ. Triglyceride-rich lipoprotein remnants, low-density lipoproteins, and risk of coronary heart disease: a UK Biobank study. Eur Heart J. 2023;44(39):4186–95. https://doi.org/10.1093/eurheartj/ehad337.CrossRefPubMedPubMedCentral

34.

Virani SS, Morris PB, Agarwala A, Ballantyne CM, Birtcher KK, Kris-Etherton PM, et al. 2021 ACC Expert Consensus decision pathway on the management of ASCVD Risk reduction in patients with persistent hypertriglyceridemia: a report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2021;78(9):960–93. https://doi.org/10.1016/j.jacc.2021.06.011.CrossRefPubMed

35.

Group AS, Ginsberg HN, Elam MB, Lovato LC, Crouse JR 3rd, Leiter LA, et al. Effects of combination lipid therapy in type 2 diabetes mellitus. N Engl J Med. 2010;362(17):1563–74. https://doi.org/10.1056/NEJMoa1001282.CrossRef

36.

Das Pradhan A, Glynn RJ, Fruchart JC, MacFadyen JG, Zaharris ES, Everett BM, et al. Triglyceride lowering with Pemafibrate to Reduce Cardiovascular Risk. N Engl J Med. 2022;387(21):1923–34. https://doi.org/10.1056/NEJMoa2210645.CrossRefPubMed

37.

Bhatt DL, Steg PG, Miller M, Brinton EA, Jacobson TA, Ketchum SB, et al. Cardiovascular Risk reduction with Icosapent Ethyl for Hypertriglyceridemia. N Engl J Med. 2019;380(1):11–22. https://doi.org/10.1056/NEJMoa1812792.CrossRefPubMed

38.

Sacks FM, Alaupovic P, Moye LA, Cole TG, Sussex B, Stampfer MJ, et al. VLDL, apolipoproteins B, CIII, and E, and risk of recurrent coronary events in the cholesterol and recurrent events (CARE) trial. Circulation. 2000;102(16):1886–92. https://doi.org/10.1161/01.cir.102.16.1886.CrossRefPubMed

39.

van Capelleveen JC, Bernelot Moens SJ, Yang X, Kastelein JJP, Wareham NJ, Zwinderman AH, et al. Apolipoprotein C-III levels and Incident Coronary Artery Disease Risk: the EPIC-Norfolk prospective Population Study. Arterioscler Thromb Vasc Biol. 2017;37(6):1206–12. https://doi.org/10.1161/ATVBAHA.117.309007.CrossRefPubMedPubMedCentral

40.

Scheffer PG, Teerlink T, Dekker JM, Bos G, Nijpels G, Diamant M, et al. Increased plasma apolipoprotein C-III concentration independently predicts cardiovascular mortality: the Hoorn Study. Clin Chem. 2008;54(8):1325–30. https://doi.org/10.1373/clinchem.2008.103234.CrossRefPubMed

41.

Pollin TI, Damcott CM, Shen H, Ott SH, Shelton J, Horenstein RB, et al. A null mutation in human APOC3 confers a favorable plasma lipid profile and apparent cardioprotection. Science. 2008;322(5908):1702–5. https://doi.org/10.1126/science.1161524.CrossRefPubMedPubMedCentral

42.

Jorgensen AB, Frikke-Schmidt R, Nordestgaard BG, Tybjaerg-Hansen A. Loss-of-function mutations in APOC3 and risk of ischemic vascular disease. N Engl J Med. 2014;371(1):32–41. https://doi.org/10.1056/NEJMoa1308027.CrossRefPubMed

43.

Tg, Hdl Working Group of the Exome Sequencing Project NHL, Blood I, Crosby J, Peloso GM, Auer PL, et al. Loss-of-function mutations in APOC3, triglycerides, and coronary disease. N Engl J Med. 2014;371(1):22–31. https://doi.org/10.1056/NEJMoa1307095.

44.

Lee SJ, Campos H, Moye LA, Sacks FM. LDL containing apolipoprotein CIII is an independent risk factor for coronary events in diabetic patients. Arterioscler Thromb Vasc Biol. 2003;23(5):853–8. https://doi.org/10.1161/01.ATV.0000066131.01313.EB.CrossRefPubMed

45.

Mendivil CO, Rimm EB, Furtado J, Chiuve SE, Sacks FM. Low-density lipoproteins containing apolipoprotein C-III and the risk of coronary heart disease. Circulation. 2011;124(19):2065–72. https://doi.org/10.1161/CIRCULATIONAHA.111.056986.CrossRefPubMedPubMedCentral

46.

Jensen MK, Rimm EB, Furtado JD, Sacks FM. Apolipoprotein C-III as a potential Modulator of the Association between HDL-Cholesterol and Incident Coronary Heart Disease. J Am Heart Assoc. 2012;1(2). https://doi.org/10.1161/JAHA.111.000232.

47.

Stroes ESG, Alexander VJ, Karwatowska-Prokopczuk E, Hegele RA, Arca M, Ballantyne CM, et al. Olezarsen, Acute Pancreatitis, and familial chylomicronemia syndrome. N Engl J Med. 2024;390(19):1781–92. https://doi.org/10.1056/NEJMoa2400201.CrossRefPubMed

48.

Watts GF, Rosenson RS, Hegele RA, Goldberg IJ, Gallo A, Mertens A, et al. Plozasiran for managing persistent chylomicronemia and pancreatitis risk. N Engl J Med. 2024. https://doi.org/10.1056/NEJMoa2409368.CrossRefPubMed

49.

Oral EA, Garg A, Tami J, Huang EA, O’Dea LSL, Schmidt H, et al. Assessment of efficacy and safety of volanesorsen for treatment of metabolic complications in patients with familial partial lipodystrophy: results of the BROADEN study: Volanesorsen in FPLD; the BROADEN Study. J Clin Lipidol. 2022;16(6):833–49. https://doi.org/10.1016/j.jacl.2022.08.008.CrossRefPubMed

50.

Alexander VJ, Karwatowska-Prokopczuk E, Prohaska TA, Li L, Geary RS, Gouni-Berthold I, et al. Volanesorsen to prevent Acute Pancreatitis in Hypertriglyceridemia. N Engl J Med. 2024;390(5):476–7. https://doi.org/10.1056/NEJMc2306575.CrossRefPubMed

51.

Gouni-Berthold I, Alexander VJ, Yang Q, Hurh E, Steinhagen-Thiessen E, Moriarty PM, et al. Efficacy and safety of volanesorsen in patients with multifactorial chylomicronaemia (COMPASS): a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Diabetes Endocrinol. 2021;9(5):264–75. https://doi.org/10.1016/S2213-8587(21)00046-2.CrossRefPubMed

52.

Gaudet D, Pall D, Watts GF, Nicholls SJ, Rosenson RS, Modesto K, et al. Plozasiran (ARO-APOC3) for severe hypertriglyceridemia: the SHASTA-2 Randomized Clinical Trial. JAMA Cardiol. 2024;9(7):620–30. https://doi.org/10.1001/jamacardio.2024.0959.CrossRefPubMed

53.

Ballantyne CM, Vasas S, Azizad M, Clifton P, Rosenson RS, Chang T, et al. Plozasiran, an RNA interference Agent Targeting APOC3, for mixed hyperlipidemia. N Engl J Med. 2024. https://doi.org/10.1056/NEJMoa2404143.CrossRefPubMed

54.

Bergmark BA, Marston NA, Prohaska TA, Alexander VJ, Zimerman A, Moura FA, et al. Olezarsen for Hypertriglyceridemia in patients at High Cardiovascular Risk. N Engl J Med. 2024;390(19):1770–80. https://doi.org/10.1056/NEJMoa2402309.CrossRefPubMed

55.

Berry JD, Liu K, Folsom AR, Lewis CE, Carr JJ, Polak JF, et al. Prevalence and progression of subclinical atherosclerosis in younger adults with low short-term but high lifetime estimated risk for cardiovascular disease: the coronary artery risk development in young adults study and multi-ethnic study of atherosclerosis. Circulation. 2009;119(3):382–9. https://doi.org/10.1161/CIRCULATIONAHA.108.800235.CrossRefPubMedPubMedCentral

56.

Arrowhead Pharmaceuticals I. Arrowhead Pharmaceuticals to Advance RNAi-based Plozasiran into Phase 3 CAPITAN Cardiovascular Outcomes Trial. https://ir.arrowheadpharma.com/news-releases/news-release-details/arrowhead-pharmaceuticals-advance-rnai-based-plozasiran-phase-32024

57.

Dewey FE, Gusarova V, Dunbar RL, O’Dushlaine C, Schurmann C, Gottesman O, et al. Genetic and pharmacologic inactivation of ANGPTL3 and Cardiovascular Disease. N Engl J Med. 2017;377(3):211–21. https://doi.org/10.1056/NEJMoa1612790.CrossRefPubMedPubMedCentral

58.

Rosenson RS, Gaudet D, Hegele RA, Ballantyne CM, Nicholls SJ, Lucas KJ, et al. Zodasiran, an RNAi therapeutic targeting ANGPTL3, for mixed hyperlipidemia. N Engl J Med. 2024. https://doi.org/10.1056/NEJMoa2404147.CrossRefPubMed

59.

Raal FJ, Rosenson RS, Reeskamp LF, Hovingh GK, Kastelein JJP, Rubba P, et al. Evinacumab for homozygous familial hypercholesterolemia. N Engl J Med. 2020;383(8):711–20. https://doi.org/10.1056/NEJMoa2004215.CrossRefPubMed

60.

Rosenson RS, Gaudet D, Ballantyne CM, Baum SJ, Bergeron J, Kershaw EE, et al. Evinacumab in severe hypertriglyceridemia with or without lipoprotein lipase pathway mutations: a phase 2 randomized trial. Nat Med. 2023;29(3):729–37. https://doi.org/10.1038/s41591-023-02222-w.CrossRefPubMedPubMedCentral

61.

Rosenson RS, Rader DJ, Ali S, Banerjee P, McGinniss J, Pordy R. Evinacumab Reduces Triglyceride-Rich Lipoproteins in patients with hyperlipidemia: a post-hoc analysis of three randomized clinical trials. Cardiovasc Drugs Ther. 2024. https://doi.org/10.1007/s10557-024-07567-z.CrossRefPubMed

62.

Bergmark BA, Marston NA, Bramson CR, Curto M, Ramos V, Jevne A, et al. Effect of Vupanorsen on Non-high-density Lipoprotein Cholesterol Levels in statin-treated patients with elevated cholesterol: TRANSLATE-TIMI 70. Circulation. 2022;145(18):1377–86. https://doi.org/10.1161/CIRCULATIONAHA.122.059266.CrossRefPubMedPubMedCentral

63.

Dewey FE, Gusarova V, O’Dushlaine C, Gottesman O, Trejos J, Hunt C, et al. Inactivating variants in ANGPTL4 and risk of coronary artery disease. N Engl J Med. 2016;374(12):1123–33. https://doi.org/10.1056/NEJMoa1510926.CrossRefPubMedPubMedCentral

64.

Deng M, Kutrolli E, Sadewasser A, Michel S, Joibari MM, Jaschinski F, et al. ANGPTL4 silencing via antisense oligonucleotides reduces plasma triglycerides and glucose in mice without causing lymphadenopathy. J Lipid Res. 2022;63(7):100237. https://doi.org/10.1016/j.jlr.2022.100237.CrossRefPubMedPubMedCentral

65.

AB LP. The Swedish Medical Products Agency approves Lipigon’s phase II study with Lipisense^®. https://www.lipigon.se/en/investors/press-releases/?slug=the-swedish-medical-products-agency-approves-lipigon-s-phase-969132024

66.

Loomba R, Sanyal AJ, Kowdley KV, Bhatt DL, Alkhouri N, Frias JP, et al. Randomized, controlled trial of the FGF21 Analogue Pegozafermin in NASH. N Engl J Med. 2023;389(11):998–1008. https://doi.org/10.1056/NEJMoa2304286.CrossRefPubMedPubMedCentral

67.

Bhatt DL, Bays HE, Miller M, Cain JE 3rd, Wasilewska K, Andrawis NS, et al. The FGF21 analog pegozafermin in severe hypertriglyceridemia: a randomized phase 2 trial. Nat Med. 2023;29(7):1782–92. https://doi.org/10.1038/s41591-023-02427-z.CrossRefPubMedPubMedCentral

Title: The Emerging Potential of Apolipoprotein C-III Inhibition for ASCVD Prevention: A State-of-the-Art Review
Authors: Samuel D. Maidman
Robert A. Hegele
Robert S. Rosenson
Publication date: 14-11-2024
Publisher: Springer US
Keywords: Coronary Heart Disease
Hypertriglyceridemia
Arterial Occlusive Disease
Drug Therapy in Internal Medicine
Dyslipidemia
Published in: Current Atherosclerosis Reports / Issue 1/2024
Print ISSN: 1523-3804
Electronic ISSN: 1534-6242
DOI: https://doi.org/10.1007/s11883-024-01258-8

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