HDL/apoA-I infusion for atherosclerosis management: an emerging therapeutic paradigm

Atherothrombotic vascular disease is the leading cause of death in much of the Western world. Therapeutic lifestyle modification, risk factor control and statin-mediated low-density lipoprotein cholesterol (LDL-C)-lowering have been shown to significantly reduce atherothrombotic cardiovascular events. However, nearly two-thirds of adverse cardiovascular events continue to occur despite current interventions. In view of the known epidemiological data showing an inverse relationship between coronary heart disease and high-density lipoprotein-cholesterol (HDL-C), and coupled with experimental observations and proof-of-concept early clinical trials, the focus is now shifting to HDL as a therapeutic strategy for further cardiovascular risk reduction. Direct infusion of recombinant HDL/apolipoprotein A-I is one such promising approach that is reviewed in this paper.