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Cell-free Biochemical Fluorometric Enzymatic Assay for High-throughput Measurement of Lipid Peroxidation in High Density Lipoprotein
Published on: October 12, 2017
High-density lipoprotein particles, coronary heart disease, and niacin
1Lipid Metabolism Laboratory, Tufts University, 711 Washington Street, Boston, MA 02111, USA. bela.asztalos@tufts.edu
Insights
Despite statin therapy reducing cardiovascular events, many patients still face residual risk. Targeting high-density lipoprotein cholesterol (HDL-C) is a promising strategy to further decrease cardiovascular disease (CVD) risk.
Area of Science:
- Cardiology
- Lipid Metabolism
- Preventive Medicine
Background:
- Statins significantly reduce cardiovascular disease (CVD) events by lowering LDL-C.
- A substantial percentage of patients on statins experience residual CVD events, indicating unmet needs.
- Low high-density lipoprotein cholesterol (HDL-C) is an independent CVD risk factor.
Purpose of the Study:
- To explore HDL-C as a therapeutic target for reducing residual CVD risk in statin-treated patients.
- To highlight the established role of HDL-C levels in cardiovascular risk stratification.
Main Methods:
- Review of epidemiological and cross-sectional studies.
- Analysis of Framingham Heart Study data to define HDL-C thresholds.
- Examination of current clinical guidelines for HDL-C levels.
Main Results:
- Low HDL-C (<40 mg/dl in men, <50 mg/dl in women) is an independent risk factor for CVD.
- HDL-C levels above 60 mg/dl are associated with a protective effect against CVD.
- Despite significant LDL-C reduction, residual CVD risk persists in many patients.
Conclusions:
- Targeting HDL-C represents a logical next step in managing residual CVD risk.
- Optimizing HDL-C levels may offer a novel therapeutic approach to further reduce cardiovascular events.
- Further research into HDL-C-raising therapies is warranted for high-risk populations.
Abstract:
The use of statins in patients with high risk for cardiovascular disease (CVD) has resulted in a 30-40% decrease in clinical events in the last couple of decades. However, despite of a marked reduction (up to 60%) in LDL-C, about 30% of patients continue to have CVD events. This high residual risk in statin-treated patients initiated the search for new ways to reduce CVD risk. HDL is the next logical target. Epidemiological and cross-sectional studies identified low HDL-C level as an independent risk for CVD. Based on the Framingham Heart Study data, HDL-C <35 mg/dl was established an independent risk factor and HDL-C >60 mg/dl as protective.(3) Presently the cut point is <40 mg/dl for men and <50 mg/dl for women.
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