Update of HDL in atherosclerotic cardiovascular disease
Clin Investig Arterioscler. 2023 Nov-Dec;35(6):297-314.
doi: 10.1016/j.arteri.2023.10.002.
Epub 2023 Nov 7.
[Article in
English,
Spanish]
Affiliations
- 1 Cardiovascular Program, Institut de Recerca, Hospital de la Santa Creu I Sant Pau, IIB Sant Pau, 08025 Barcelona, Spain; Faculty of Medicine, University of Barcelona (UB), 08036 Barcelona, Spain.
- 2 Cardiovascular Program, Institut de Recerca, Hospital de la Santa Creu I Sant Pau, IIB Sant Pau, 08025 Barcelona, Spain.
- 3 Imperial College, London, United Kingdom.
- 4 Cardiology Unit, Cardiovascular Clinical Institute, Hospital Clínic de Barcelona, Barcelona, Spain.
- 5 Cardiovascular Program, Institut de Recerca, Hospital de la Santa Creu I Sant Pau, IIB Sant Pau, 08025 Barcelona, Spain; Cardiovascular Research Chair, UAB, 08025 Barcelona, Spain; CiberCV, Institute of Health Carlos III, Madrid, Spain.
- 6 Cardiovascular Program, Institut de Recerca, Hospital de la Santa Creu I Sant Pau, IIB Sant Pau, 08025 Barcelona, Spain; CiberCV, Institute of Health Carlos III, Madrid, Spain. Electronic address: gvilahur@santpau.cat.
Abstract
Epidemiologic evidence supported an inverse association between HDL (high-density lipoprotein) cholesterol (HDL-C) levels and atherosclerotic cardiovascular disease (ASCVD), identifying HDL-C as a major cardiovascular risk factor and postulating diverse HDL vascular- and cardioprotective functions beyond their ability to drive reverse cholesterol transport. However, the failure of several clinical trials aimed at increasing HDL-C in patients with overt cardiovascular disease brought into question whether increasing the cholesterol cargo of HDL was an effective strategy to enhance their protective properties. In parallel, substantial evidence supports that HDLs are complex and heterogeneous particles whose composition is essential for maintaining their protective functions, subsequently strengthening the "HDL quality over quantity" hypothesis. The following state-of-the-art review covers the latest understanding as per the roles of HDL in ASCVD, delves into recent advances in understanding the complexity of HDL particle composition, including proteins, lipids and other HDL-transported components and discusses on the clinical outcomes after the administration of HDL-C raising drugs with particular attention to CETP (cholesteryl ester transfer protein) inhibitors.
Keywords:
Aterosclerosis; Atherosclerosis; Cardiovascular disease; Enfermedad cardiovascular; HDL; Terapia; Therapy.
Copyright © 2023 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.
MeSH terms
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Atherosclerosis* / drug therapy
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Atherosclerosis* / etiology
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Cardiovascular Diseases* / drug therapy
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Cardiovascular Diseases* / etiology
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Cardiovascular Diseases* / prevention & control
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Cholesterol / metabolism
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Cholesterol Ester Transfer Proteins / therapeutic use
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Cholesterol, HDL
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Humans
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Lipoproteins, HDL / metabolism
Substances
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Cholesterol Ester Transfer Proteins
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Cholesterol
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Lipoproteins, HDL
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Cholesterol, HDL