Atherosclerotic cardiovascular disease (ASCVD) is one of the major leading global causes of death. Genetic and epidemiological studies strongly support the causal association between triacylglycerol-rich lipoproteins (TAGRL) and atherogenesis, even in statin-treated patients. Recent genetic evidence has clarified that variants in several key genes implicated in TAGRL metabolism are strongly linked to the increased ASCVD risk. There are several triacylglycerol-lowering agents; however, new therapeutic options are in development, among which are miRNA-based therapeutic approaches. MicroRNAs (miRNAs) are small non-coding RNAs (18–25 nucleotides) that negatively modulate gene expression through translational repression or degradation of target mRNAs, thereby reducing the levels of functional genes. MiRNAs play a crucial role in the development of hypertriglyceridemia as several miRNAs are dysregulated in both synthesis and clearance of TAGRL particles. MiRNA-based therapies in ASCVD have not yet been applied in human trials but are attractive. This review provides a concise overview of current interventions for hypertriglyceridemia and the development of novel miRNA and siRNA-based drugs. We summarize the miRNAs involved in the regulation of key genes in the TAGRLs synthesis pathway, which has gained attention as a novel target for therapeutic applications in CVD.

动脉粥样硬化性心血管疾病 (ASCVD) 是全球主要的死亡原因之一。遗传学和流行病学研究强烈支持富含三酰甘油的脂蛋白 (TAGRL) 与动脉粥样硬化形成之间的因果关系，即使在接受他汀类药物治疗的患者中也是如此。最近的遗传学证据表明，涉及 TAGRL 代谢的几个关键基因的变异与 ASCVD 风险增加密切相关。有几种甘油三酯降低剂；然而，新的治疗选择正在开发中，其中包括基于 miRNA 的治疗方法。微小 RNA (miRNA) 是小的非编码 RNA（18-25 个核苷酸），可通过翻译抑制或靶 mRNA 的降解来负向调节基因表达，从而降低功能基因的水平。MiRNA 在高甘油三酯血症的发展中起着至关重要的作用，因为几种 miRNA 在 TAGRL 颗粒的合成和清除中失调。ASCVD 中基于 MiRNA 的疗法尚未应用于人体试验，但很有吸引力。本综述简要概述了当前高甘油三酯血症的干预措施以及新型 miRNA 和基于 siRNA 的药物的开发。我们总结了参与调节 TAGRL 合成途径中关键基因的 miRNA，该途径作为 CVD 治疗应用的新靶点而受到关注。本综述简要概述了当前高甘油三酯血症的干预措施以及新型 miRNA 和基于 siRNA 的药物的开发。我们总结了参与调节 TAGRL 合成途径中关键基因的 miRNA，该途径作为 CVD 治疗应用的新靶点而受到关注。本综述简要概述了当前高甘油三酯血症的干预措施以及新型 miRNA 和基于 siRNA 的药物的开发。我们总结了参与调节 TAGRL 合成途径中关键基因的 miRNA，该途径作为 CVD 治疗应用的新靶点而受到关注。