title: High-density Lipoprotein and Low-density Lipoprotein Therapeutic Approaches in Acute Coronary Syndromes.
abstract: BACKGROUND
  Low-density lipoprotein cholesterol (LDL), and especially its oxidized form, renders the atherosclerotic plaque vulnerable to rupture in acute coronary syndromes (ACS). On the other hand, high-density lipoprotein (HDL) is considered an anti-atherogenic molecule. The more recent HDL-targeted drugs may prove to be superior to those used before. Indeed, delipidated HDL and HDL mimetics are efficient in increasing HDL levels, while the apoA-I upregulation with RVX-208 appears to offer a clinical benefit which is beyond the HDL related effects. HDL treatment however has not shown a significant improvement in the outcomes of patients with ACS so far, studies have therefore focused again on LDL. In addition to statins and ezetimibe, novel drugs such as PSCK9 inhibitors and apolipoprotein B inhibitors appear to be both effective and safe for patients with hyperlipidemia.
  
  
  CONCLUSIONS
  Data suggest these could potentially improve the cardiovascular outcomes of patient with ACS. Yet, there is still research to be done, in order to confirm whether ACS patients would benefit from LDL- or HDL-targeted therapies or a combination of both.
authors.affiliation: St George's University Hospital, London, United Kingdom.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Androulakis
authors.affiliation: 1st Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece.
authors.forename: Effimia
authors.initials: E
authors.lastname: Zacharia
authors.affiliation: Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, EC1A 7BE, London, United Kingdom.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papageorgiou
authors.affiliation: Epsom and St Helier University Hospitals, London, United Kingdom.
authors.forename: Eirini
authors.initials: E
authors.lastname: Lioudaki
authors.affiliation: 1st Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece.
authors.forename: Dimitris
authors.initials: D
authors.lastname: Bertsias
authors.affiliation: Department of Cardiovascular Imaging, King's College London, United Kingdom.
authors.forename: Marietta
authors.initials: M
authors.lastname: Charakida
authors.affiliation: 1st Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece.
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Siasos
authors.affiliation: 1st Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece.
authors.forename: Dimitris
authors.initials: D
authors.lastname: Tousoulis
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000188:drug therapy*; D015415:Biomarkers / Q000097:blood; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008075:Lipoproteins, HDL / Q000097:blood*; D008077:Lipoproteins, LDL / Q000097:blood*
chemical_list: D015415:Biomarkers; D000960:Hypolipidemic Agents; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL
keywords: High-density lipoprotein; acute coronary syndromes; atherosclerosis; ezetimibe; lipidlowering
  drugs; low-density lipoprotein; outcomes; statins