Circular RNA role in Atherosclerosis Development and Progression

Purpose of Review: Circular RNAs (circRNAs), a distinct class of long noncoding RNAs characterized by covalently closed-loop structures, have emerged as pivotal regulators of gene expression. Their stability, abundance, and cell-type specificity make them increasingly relevant in cardiovascular disease pathogenesis and clinical management. Atherosclerosis, a chronic inflammatory disorder of the arterial wall, underlies many cardiovascular and cerebrovascular events, including myocardial infarction and stroke. This review provides a comprehensive analysis of circRNAs’ influence on the development and progression of atherosclerotic plaques. Recent Findings: The role of circRNAs in atherogenesis, where they may function as atheroprotective or atherogenic factors by modulating endothelial and smooth muscle cell functions, macrophage activity, lipid metabolism, and inflammatory signaling, has recently emerged. Summary: This review explores both experimental and in vivo findings on the functions of specific circRNAs and their involvement in cellular autophagy, apoptosis, oxidative stress, and vascular remodeling. Additionally, the diagnostic potential of circulating circRNAs as biomarkers for plaque instability and rupture has been investigated. Understanding circRNA-mediated regulatory networks may open new avenues for precision diagnostics and targeted therapies in atherosclerotic cardiovascular disease.