Intensive Cholesterol Treatment Shrinks Coronary Plaque
An 18-month study found intensive cholesterol therapy reduced plaque in heart patients' coronary arteries by about 20%.
Updated on Nov. 4, 2026 in Heart Disease
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A study published in October found that intensive cholesterol treatment reduced plaque in heart patients' coronary arteries by about 20% over 18 months. Heart disease remains the leading cause of death in America.
Why it matters
Plaque buildup in coronary arteries drives heart attacks, and heart disease remains the leading cause of death in the United States. Injections, costs and insurance restrictions have limited the use of PCSK9 inhibitors, which help the liver clear LDL from the blood.
A clinical study found intensive cholesterol treatment cut coronary plaque by about 20% over 18 months, and adding Repatha to standard therapy reduced estimated five-year cardiac event risk by 31% in people with diabetes but no known major artery disease. Whether these plaque changes translate into fewer heart attacks over longer periods is not addressed in the reported data.
The players
Andreessen Horowitz
A major venture capital firm that published The State of Longevity report identifying business opportunities in cardiovascular prevention.
Novartis
A Swiss pharmaceutical company whose pelacarsen trial lowered lipoprotein(a) but failed to meet its primary endpoint of reducing cardiovascular events.
The details
PCSK9 inhibitors such as Repatha help the liver clear LDL cholesterol from the blood. Lipfendra, the first PCSK9 inhibitor available as a daily pill, received FDA approval in July 2026.
Timeline
July 2026: FDA approves Lipfendra, the first daily-pill PCSK9 inhibitor.
October 2026: Study reports about 20% reduction in coronary artery plaque over 18 months.
November 3, 2026: Andreessen Horowitz publishes The State of Longevity report.
Big Picture
The newly approved daily PCSK9 pill Lipfendra extends the injectable PCSK9 inhibitor class that includes Repatha, which has been constrained by injection requirements, costs and insurance restrictions. Public awareness of the class is still limited, with only 21% of survey respondents knowing about PCSK9 inhibitors.
Patients with elevated lipoprotein(a) may want to discuss testing with a clinician, since U.S. guidelines recommend at least one test in adulthood. A once-daily PCSK9 pill may reduce the need for injections, though coverage and cost will determine access.
The takeaway
Plaque reduction is a measurable marker of heart disease progress, so patients with elevated cholesterol or lipoprotein(a) should ask their clinicians whether testing or treatment intensification fits their risk profile.
Further reading
Explore more on Heart Disease in the United States.
Source note: This article includes information reported by TokenPost.
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