Coronary heart disease (CHD) makes up approximately 42.1% of all cardiovascular disease deaths in the United States. Cholesterol deposition in the arteries from LDL-C, or the “bad cholesterol,” increases the risk of CHD, atherosclerosis, myocardial infarction, and stroke. However, increased HDL-C, “good cholesterol,” has been associated with lower risk of CHD and plays an important role in the reverse cholesterol transport (RCT) pathway. The RCT pathway is the process of cholesterol efflux from peripheral cells and tissues by HDL, and transported to the liver for uptake, excretion, and recycling. Pathogenic variants in key players within the RCT pathway, like SCARB1, ApoA-I, ABCA1/ABCG1, are associated with atherosclerosis and coronary artery disease. Thus, understanding RCT mechanisms is of significant scientific interest. In this chapter, we discuss lipoproteins, with particular emphasis on the known mechanisms of RCT, disease-associated variants, and current therapies.
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