Low high-density lipoprotein cholesterol: an important consideration in coronary heart disease risk assessment

2008 ◽  
Vol 15 (2) ◽  
pp. 175-181 ◽  
Author(s):  
Farhan Majeed ◽  
Michael Miller
Keyword(s):  
Risk Assessment ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
High Density Lipoprotein ◽  
High Density Lipoprotein Cholesterol ◽  
Coronary Heart Disease Risk ◽  
Disease Risk ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Heart Disease Risk

scholarly journals Pharmacological Inhibition of CETP (Cholesteryl Ester Transfer Protein) Increases HDL (High-Density Lipoprotein) That Contains ApoC3 and Other HDL Subspecies Associated With Higher Risk of Coronary Heart Disease

2021 ◽  
Author(s):  
Jeremy D. Furtado ◽  
Giacomo Ruotolo ◽  
Stephen J. Nicholls ◽  
Robert Dullea ◽  
Santos Carvajal-Gonzalez ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
High Density Lipoprotein ◽  
Cholesteryl Ester ◽  
Cholesteryl Ester Transfer Protein ◽  
Coronary Heart Disease Risk ◽  
Disease Risk ◽  
Density Lipoprotein ◽  
Transfer Protein ◽  
Heart Disease Risk

Objective: Plasma total HDL (high-density lipoprotein) is a heterogeneous mix of many protein-based subspecies whose functions and associations with coronary heart disease vary. We hypothesize that increasing HDL by CETP (cholesteryl ester transfer protein) inhibition failed to reduce cardiovascular disease risk, in part, because it increased dysfunctional subspecies associated with higher risk such as HDL that contains apoC3. Approach and Results: We studied participants in 2 randomized, double-blind, placebo-controlled trials of a CETP inhibitor on a background of atorvastatin treatment: ACCENTUATE (130 mg evacetrapib; n=126) and ILLUMINATE (60 mg torcetrapib; n=80). We measured the concentration of apoA1 in total plasma and 17 protein-based HDL subspecies at baseline and 3 months. Both CETP inhibitors increased apoA1 in HDL that contains apoC3 the most of all HDL subspecies (median placebo-adjusted percent increase: evacetrapib 99% and torcetrapib 50%). They also increased apoA1 in other HDL subspecies associated with higher coronary heart disease risk such as those involved in inflammation (α-2-macroglobulin and complement C3) or hemostasis (plasminogen), and in HDL that contains both apoE and apoC3, a complex subspecies associated with higher coronary heart disease risk. ApoA1 in HDL that contains apoC1, associated with lower risk, increased 71% and 40%, respectively. Only HDL that contains apoL1 showed no response to either drug. Conclusions: CETP inhibitors evacetrapib and torcetrapib increase apoA1 in HDL subspecies that contain apoC3 and other HDL subspecies associated with higher risk of coronary heart disease. Subspecies-specific effects shift HDL subspecies concentrations toward a profile associated with higher risk, which may contribute to lack of clinical benefit from raising HDL by pharmaceutical CETP inhibition.

scholarly journals Effect of serum lipid level change on 10-year coronary heart risk distribution estimated by means of seven different coronary risk scores during one-year treatment

2014 ◽  
Vol 67 (7-8) ◽  
pp. 208-215
Author(s):  
Nevena Eremic-Kojic ◽  
Mirjana Djeric ◽  
Jadranka Dejanovic
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Heart Disease Risk ◽  
Disease Risk ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Risk Scores ◽  
Coronary Risk ◽  
One Year ◽  
Heart Disease Risk

Introduction. This study was done in order to evaluate the effect of serum levels of total cholesterol, triglycerides, low-density lipoprotein- cholesterol and high-density lipoprotein-cholesterol on 10-year coronary heart disease risk distribution change. Material and Methods. This study included 110 subjects of both genders (71 female and 39 male), aged 29 to 73, treated at the Outpatient Department of Atherosclerosis Prevention, Centre for Laboratory Medicine, Clinical Centre Vojvodina. The 10-year coronary heart disease risk was estimated on first examination and after one-year treatment by means of Framingham, PROCAM and SCORE coronary risk scores and their modifications (Framingham Adult Treatment Panel III, Framingham Weibul, PROCAM NS and PROCAM Cox Hazards). Age, gender, systolic and diastolic blood pressure, smoking, positive family history and left ventricular hypertrophy are risk factors involved in the estimation of coronary heart disease besides lipid parameters. Results. There were no significant differences in nutritional status, smoking habits, systolic and diastolic pressure, and no development of diabetes mellitus or cardiovascular incidents during oneyear follow. However, a significant reduction in cholesterol level (p<0.001), triglycerides (p<0.001), low-density lipoprotein cholesterol (p<0.001) and an increase in high-density lipoprotein cholesterol (p<0.02) was present although therapeutic target values were not achieved. In addition, a significant increase was observed in the category of low 10-year coronary heart disease risk (Framingham- p<0.001; Framingham ATP III- p<0.001; Framingham Weibul- p<0.001; PROCAM- p<0.05; PROCAM NSp< 0.05; PROCAM Cox Hazards- p<0.001; SCORE- p<0.001) and a reduction in high-risk category (Framingham- p<0.001; Framingham ATP III- p<0.005; Framingham Weibul- p<0.005; PROCAM- p<0.001; PROCAM NS-p<0.001; PROCAM Cox Hazards- p<0.001; SCORE- p<0.005) in comparison with the risk at the beginning of the study. Conclusion. Our results show that the correction of lipid level after one-year treatment leads to a significant redistribution of 10-year coronary heart disease risk estimated by means of seven different coronary risk scores. This should stimulate patients and doctors to persist in prevention measures.

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