High density lipoprotein (HDL) cholesterol is a strong predictor of reduced cardiovascular mortality in the general population, and drugs to increase HDL cholesterol have been seen as potential successors to statins – which have been huge profit makes for the pharmaceutical industry. But none developed so far has shown any protective effect. And a new study shows that it is extremely unlikely that raising HDL cholesterol will ever be a viable approach to secondary prevention in established coronary artery disease.
The LUdwigshafen Risk and Cardiovascular health (LURIC) study provides 10 year follow-up data for 699 people without coronary artery disease, and 927 with unstable coronary artery disease.
In this and two other cohorts, there was no relation between levels of HDL cholesterol and cardiovascular mortality in those with established coronary artery disease.
Silbernagel, G., Schottker, B., Appelbaum, S. Scharnagl, H., Kleber, M.E., Grammer, T.B., Ritsch, A., Mons, U., Holleczek, B., Goliasch, G., Niessner, A., Boehm, B.O., Schnabel, R.B., Brenner, H., Blankenberg, S., Landmesser, U. & Marz, W. (2013) High-Density Lipoprotein Cholesterol, Coronary Artery Disease, and Cardiovascular Mortality. European Heart Journal. doi: 10.1093/eurheartj/eht343