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Drugs targeting high-density lipoprotein cholesterol for coronary artery disease management

Pamela M Katz1, Lawrence A Leiter

  • 1Division of Endocrinology and Metabolism, Department of Medicine, University of Manitoba, Winnipeg, MB, Canada.

The Canadian Journal of Cardiology
|August 21, 2012
PubMed

Insights

Many patients still face cardiovascular risks even with statin therapy. Research focuses on raising high-density lipoprotein cholesterol (HDL-C) to reduce this residual risk, but current treatments show limited success.

Area of Science:

  • Cardiology
  • Pharmacology
  • Lipid Metabolism

Background:

  • Despite statin therapy, many patients experience residual cardiovascular risk.
  • Low-density lipoprotein cholesterol (LDL-C) levels may be at or below target.
  • High-density lipoprotein cholesterol (HDL-C) is an inverse predictor of cardiovascular disease.

Purpose of the Study:

  • To explore strategies for reducing residual cardiovascular risk.
  • To evaluate the therapeutic potential of raising HDL-C levels.
  • To assess the efficacy of cholesteryl ester transfer protein (CETP) inhibitors.

Main Methods:

  • Review of current therapeutic strategies for cardiovascular risk reduction.
  • Analysis of the role of HDL-C as a therapeutic target.
  • Evaluation of clinical outcome data from CETP inhibitor trials.

Main Results:

  • Current agents that raise HDL-C have modest effects.
  • Limited evidence supports additional cardiovascular risk reduction with existing HDL-C-raising agents.
  • Clinical outcome studies of CETP inhibitors have been disappointing to date.

Conclusions:

  • Reducing residual cardiovascular risk remains a significant clinical challenge.
  • Targeting HDL-C is an attractive strategy, but current therapies are insufficient.
  • Further research and development of novel therapies, including advanced CETP inhibitors, are needed.

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