New Treatments & Clinical Trials for Atherosclerosis

Atherosclerosis is the buildup of fatty plaque inside arteries, narrowing them and restricting blood flow. It underlies most heart attacks and strokes. Current treatment centers on statins to lower cholesterol, blood pressure medications, and lifestyle changes, with procedures like stents or bypass surgery when arteries become severely blocked.

What's actually going on in research

Trials are testing drugs that target inflammation in artery walls, PCSK9 inhibitors that drastically lower LDL cholesterol, gene therapies aimed at lipid metabolism, and medications that might reverse existing plaque. Researchers are also studying how gut bacteria, chronic inflammation, and specific immune pathways drive plaque formation and rupture.

What to know before you search

Eligibility typically depends on cholesterol levels, history of heart attack or stroke, presence of plaque on imaging, and whether current medications have achieved treatment goals.

What types of trials are currently open

• Prevention trials — Testing whether new drugs reduce heart attacks and strokes in people with atherosclerosis, often following participants for years to count events.
• Lipid-lowering trials — Studies of statins, PCSK9 inhibitors, bempedoic acid, and other drugs that lower cholesterol levels. Often combined with imaging to see effects on plaque.
• Inflammation trials — Testing drugs that reduce inflammation markers like C-reactive protein, studying whether this prevents plaque rupture independent of cholesterol lowering.
• Imaging studies — Using CT scans or ultrasound to measure plaque in coronary or carotid arteries and track changes over time with different treatments.
• Gene therapy trials — Early-stage studies of gene editing or gene silencing to permanently alter cholesterol metabolism or inflammation pathways.