High-density lipoprotein infusion therapy: A review

Area of Science:

• Cardiovascular Medicine
• Biochemistry
• Medical Imaging

Background:

• Increased cholesterol-rich, non-calcified atheromas predict myocardial infarction better than traditional markers.
• Low high-density lipoprotein (HDL) cholesterol is an independent risk factor for coronary artery disease (CAD).
• Small, lipid-poor preβ-1 HDL particles are effective in cellular cholesterol efflux.

Purpose of the Study:

• To review animal and human studies on HDL infusion therapy for atherosclerosis regression.
• To explore reasons for variable outcomes in HDL infusion studies.

Main Methods:

• Review of animal studies demonstrating HDL's effect on aortic atherosclerosis.
• Analysis of human clinical trials using HDL mimetics and native HDL infusions.
• Examination of studies employing intravascular ultrasound and computed coronary angiography for atherosclerosis assessment.

Main Results:

• HDL infusions reduced aortic atherosclerosis in animal models.
• Some human studies with HDL mimetics or complexes yielded negative results for coronary atherosclerosis progression.
• A study using autologous delipidated HDL infusions showed significant regression of coronary atheroma in familial hypercholesterolemic patients.

Conclusions:

• HDL infusion therapy shows promise for atherosclerosis regression, particularly with autologous delipidated HDL.
• Variability in results may stem from differences in HDL preparations, patient selection, and imaging assessment techniques.
• Further research is needed to optimize HDL-based therapies for cardiovascular disease.