Background and objectives: Controlling coronary artery plaque regression is essential for the treatment of cardiovascular diseases, as it directly influences patient outcomes. Although advancements have been made in imaging and pharmacotherapy, significant challenges remain in accurately assessing plaque changes and managing associated treatment side effects. This article aimed to explore the current state of coronary artery plaque regression management, including the limitations of existing imaging technologies and the side effects of lipid-lowering treatments, as well as potential future approaches. Methods: A comprehensive review of the literature was conducted, focusing on advancements in imaging modalities, pharmacological treatments, and patient management strategies for coronary artery disease (CAD). Special attention was paid to the challenges of assessing plaque dynamics and the clinical implications of long-term treatment strategies. Results: Imaging modalities for plaque assessment continue to face limitations, particularly in providing comprehensive examinations of plaque changes. Although lipid-lowering therapies are effective in reducing plaque burden, they are associated with side effects that affect patient adherence. Long-term lifestyle changes are difficult to maintain, further hindering plaque regression. Despite these challenges, novel medications and an enhanced understanding of plaque biology offer promise for improving treatment outcomes. Conclusion: Effective management of coronary artery plaque regression remains a critical factor in reducing the global burden of cardiovascular disease. Future treatment strategies should focus on optimizing patient adherence, minimizing the adverse effects of therapy, and leveraging innovative imaging technologies for the more accurate detection and treatment of atherosclerosis. Addressing these challenges will significantly enhance preventive efforts and patient care [1].
