January 10, 2026Current Cardiology Reports0 citationsOpen Access
Targeting Triglycerides in Cardiovascular Disease Prevention: Evidence, Mechanisms, and Emerging Therapies
Key Result
Selective triglyceride-lowering therapies targeting apolipoprotein B may provide clinical benefit in high-risk cardiovascular disease populations, pending ongoing trial results.
Key Points
- Evaluate the role of triglycerides and triglyceride-rich lipoproteins in cardiovascular disease risk and prevention.
- Review genetic and epidemiological evidence regarding triglyceride levels and cardiovascular disease.
- Examine the therapeutic potential of emerging triglyceride-targeting agents.
- Analyze recent data from Mendelian randomization studies and clinical cohorts.
- Emerging studies indicate a causal link between elevated remnant lipoproteins and atherosclerotic cardiovascular disease.
- Traditional triglyceride-lowering agents showed inconsistent cardiovascular outcomes, while ApoC-III and ANGPTL3 inhibitors exhibited strong lipid-lowering effects.
- Selective PPAR modulators have not shown cardiovascular benefits yet, necessitating further investigation.
Structured PICO
Do triglyceride-lowering therapies reduce cardiovascular disease risk in high-risk populations?
P
Population
High-risk populations with elevated triglycerides (TGs) and TG-rich lipoproteins (TRLs), particularly those with diabetes, metabolic syndrome, or chronic kidney disease
I
Intervention
Triglyceride-lowering therapies, including traditional agents (fibrates, omega-3 fatty acids) and emerging therapies (ApoC-III inhibitors, ANGPTL3 inhibitors, selective PPAR modulators)
O
Outcome
Cardiovascular disease (CVD) risk and residual risk reduction
Selective triglyceride-lowering strategies targeting triglyceride-rich lipoproteins, especially those that decrease apolipoprotein B, may provide clinical benefit in high-risk phenotypes to address residual cardiovascular risk.
Main Result
Absolute Event Rate: 0% vs 0%
Abstract
Abstract Purpose of Review The goal of this review is to evaluate the evolving role of triglycerides (TGs) and TG-rich lipoproteins (TRLs) in cardiovascular disease (CVD) risk and prevention. We examine the mechanistic rationale, genetic and epidemiological evidence, and therapeutic potential of targeting TGs in residual risk reduction, particularly in high-risk populations. Recent Findings Emerging data from Mendelian randomization studies and large clinical cohorts support a causal link between elevated remnant lipoproteins and atherosclerotic CVD, in which apolipoprotein B may be the principal driver. Although traditional triglyceride-lowering agents have produced mixed results on cardiovascular outcomes, emerging therapies—such as ApoC-III and ANGPTL3 inhibitors—show robust lipid-lowering effects, while selective PPAR modulators have thus far not demonstrated cardiovascular benefit. However, outcome data remain limited. Summary Residual CVD risk persists despite aggressive LDL-C reduction, especially in patients with diabetes, metabolic syndrome, or chronic kidney disease. Selective TG-lowering strategies targeting TRLs—especially those that decrease apolipoprotein B—may provide clinical benefit in high-risk phenotypes. Ongoing trials will clarify whether these promising agents confer meaningful cardiovascular protection and warrant integration into future guidelines.