HDL as a prognostic biomarker for coronary atherosclerosis: the role of inflammation

Area of Science:

• Cardiovascular Science
• Lipid Metabolism
• Atherosclerosis Research

Background:

• Emerging evidence challenges the traditionally atheroprotective role of high-density lipoprotein (HDL).
• HDL's protective functions can shift to become atherogenic under heightened inflammatory conditions.
• Systemic inflammation can impair the endothelial protective effects of HDL.

Purpose of the Study:

• To review HDL's role as a prognostic biomarker in atherosclerosis.
• To discuss therapeutic strategies aimed at increasing HDL levels and their clinical implications.
• To explore the complex relationship between HDL, inflammation, and cardiovascular disease.

Main Methods:

• Literature review of current evidence on HDL function and atherosclerosis.
• Analysis of studies investigating HDL-modifying therapies.
• Discussion of the prognostic value of HDL in coronary atherosclerosis.

Main Results:

• The atheroprotective capacity of HDL is compromised in inflammatory states.
• HDL-modifying drugs show some efficacy in reducing cardiovascular mortality, but results are not consistently encouraging.
• The structural and functional complexity of HDL contributes to its unclear role in atherosclerosis.

Conclusions:

• HDL's role in atherosclerosis is complex and context-dependent, particularly influenced by inflammation.
• Current therapeutic approaches targeting HDL levels may not be universally effective.
• Future research should focus on quantifying HDL subclasses and functions to guide targeted therapies for cardiovascular disease.