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J Am Coll Cardiol, 2004; 43:717-724, doi:10.1016/j.jacc.2003.08.061
© 2004 by the American College of Cardiology Foundation
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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{dagger}

* Weill Medical College of Cornell University, New York, New York, USA
{dagger} 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.

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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