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Importance of Assessing the Effect of Statins on the Function of High- Density Lipoproteins on Coronary Plaque

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High-density lipoproteins (HDL) are small particles comprised of phospholipids and stabilizing proteins, which carry cholesterol and triglycerides in the blood stream. The incidence of cardiovascular events is high in patients with low level of HDL-cholesterol (HDL-C). In the present study, we defined The PH index [Δcoronary plaque volume/ΔHDL-C] index as a putative clinical index of cholesterol efflux capacity of HDL from atheromatous plaque. The present study investigated the PH index in response to treatment with different types of HMG-CoA reductase inhibitors (statins), in contrast to similar changes in the PL index [Δcoronary plaque volume/Δlow-density lipoprotein-cholesterol (LDL-C)] by the same statins. Using the 2000-2011 PubMed database, the search keywords were “statins” and “intravascular ultrasound (IVUS)” and “plaque volume”. Cross references were checked. PubMed search identified 29 references, and finally 4 published studies were selected for data analysis. The PL index, representing the change in plaque volume induced by 1% reduction in LDL-C, showed no difference among the different statins. On the other hand, the PH index, representing the change in plaque volume induced by 1% increase in HDL-C, showed wide variability among the different statins; 1.4 by atorvastatin, 1.0 by pravastatin, -0.1 by simvastatin, -0.2 or -0.5 by rosuvastatin, and -1.8 by pitavastatin. In conclusion, the best coronary plaque regression index attributed to HDL-cholesterol elevation (PH index) was found in pitavastatin treatment, in comparison with the other 4 statins (atorvastatin, pravastatin, simvastatin, rosuvastatin) investigated in the articles scanned by their search.

Keywords: ApoA-I; HDL function; HDL-C; LDL receptor pathway; LDL-C; coronary plaque; lesions; statins

Document Type: Research Article


Publication date: 2012-09-01

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  • Cardiovascular & Hematological Disorders - Drug Targets aims to cover all the latest and outstanding developments on the medicinal chemistry, pharmacology, molecular biology, genomics and biochemistry of contemporary molecular targets involved in cardiovascular and hematological disorders e.g. disease specific proteins, receptors, enzymes, genes. Each issue of the journal will contain a series of timely in-depth reviews written by leaders in the field covering a range of current topics on drug targets involved in cardiovascular and hematological disorders. As the discovery, identification, characterization and validation of novel human drug targets for cardiovascular and hematological drug discovery continues to grow; this journal will be essential reading for all pharmaceutical scientists involved in drug discovery and development.
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