title: High Density Lipoprotein Cholesterol Increasing Therapy: The Unmet Cardiovascular Need.
abstract: Despite aggressive strategies are now available to reduce LDL-cholesterol, the risk of cardiovascular events in patients with coronary artery disease remains substantial. Several preclinical and clinical studies have shown that drug therapy ultimately leads to a regression of the angiographic lesions but also results in a reduction in cardiovascular events. The dramatic failure of clinical trials evaluating the cholesterol ester transfer protein (CEPT) inhibitors, torcetrapib and dalcetrapib, has led to considerable doubt about the value of the current strategy to raise high-density lipoprotein cholesterol (HDL-C) as a treatment for cardiovascular disease. These clinical results, as well as animal studies, have revealed the complexity of HDL metabolism, assessing a more important role of functional quality compared to circulating quantity of HDL. As a result, HDL-based therapeutic interventions that maintain or enhance HDL functionality, such as improving its main property, the reverse cholesterol transport, require closer investigation. In this review, we will discuss HDL metabolism and function, clinical-trial data available for HDL-raising agents, and potential strategies for future HDL-based therapies.
authors.affiliation: Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Italy;
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cimmino
authors.affiliation: Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Italy;
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ciccarelli
authors.affiliation: Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Italy;
authors.forename: Alberto
authors.initials: A
authors.lastname: Morello
authors.affiliation: Department of Medicine, University of Salerno, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Ciccarelli
authors.affiliation: Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Italy;
authors.forename: Paolo
authors.initials: P
authors.lastname: Golino
keywords: Apolipoprotein AI; Atherosclerosis; Cholesterol Efflux; HDL; Reverse Cholesterol Transport