STATE-OF-THE-ART PAPER
Assessing low levels of high-density lipoprotein cholesterol as a risk factor in coronary heart disease
A working group report and update
Antonio M. Gotto, Jr, MD, DPhil*,* and
Eliot A. Brinton, MD
* Weill Medical College of Cornell University, New York, New York, USA
University of Utah School of Medicine, Salt Lake City, Utah, USA
Manuscript received July 17, 2002;
revised manuscript received July 28, 2003,
accepted September 19, 2003.
* Reprint requests and correspondence: Dr. Antonio M. Gotto, Jr., c/o Paula Trushin, Weill Medical College of Cornell University, 445 East 69th Street, Olin Hall 205, New York, New York 10021, USA. pat2004{at}med.cornell.edu
Clinical data show that a 1% increase in serum concentrations of high-density lipoprotein cholesterol (HDL-C) can decrease cardiovascular risk by 2% to 3%. Therefore, mechanisms affecting the level and functionality of high-density lipoprotein (HDL) and its constituents are being investigated as targets for the rational development of drugs to prevent or treat cardiovascular disease. High-density lipoprotein-related research may also increase our understanding of the link between atherosclerosis and metabolic disorders. This report and update of the HDL Working Group discusses HDL metabolism and reverse cholesterol transport, impaired HDL as a marker and a cause of proatherogenic states, and experimental and current approaches to HDL-related therapy.
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Abbreviations and Acronyms
| | ABC-A1 | = adenosine triphosphate binding cassette-A1 | | apo | = apolipoprotein | | CETP | = cholesteryl ester transfer protein | | CHD | = coronary heart disease | | FCR | = fractional catabolic rate | | HDL-C | = high-density lipoprotein cholesterol | | HL | = hepatic lipase | | LCAT | = lecithin:cholesterol acyltransferase | | LDL-C | = low-density lipoprotein cholesterol | | PPAR | = peroxisome proliferator activated receptor | | RCT | = reverse cholesterol transport | | SR-B1 | = scavenger receptor B1 | | VLDL | = very low-density lipoprotein |
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