J A Sikorski Athero Genics Alpharetta Ga Usa 2007 Elsevier Ltd All Rights Reserved

6.20.1 Disease State 460

6.20.1.1 Atherosclerosis 460

6.20.1.2 Heart Disease Imaging Methods 461

6.20.1.3 Heart Disease Mortality 461

6.20.2 Disease Basis 462

6.20.2.1 Dyslipidemia as a Risk Factor for Coronary Heart Disease 462

6.20.2.2 Lipoproteins: Composition, Structure, Function, and Lipid Transport 462

6.20.2.2.1 Very low-density lipoprotein, chylomicrons, and triglyceride transport 463

6.20.2.2.2 Low-density lipoprotein: structure and composition 463

6.20.2.2.3 High-density lipoprotein: structure and composition 464

6.20.2.3 The Role of Modified Low-Density Lipoprotein, Inflammatory Mediators, and

Reactive Oxygen Species (ROS) in Atherosclerosis 466

6.20.2.3.1 Low-density lipoprotein oxidation, modification, and retention 467

6.20.2.3.2 The antioxidant paradox 469

6.20.2.3.3 The atheroprotective effects of high-density lipoprotein cholesterol 470

6.20.2.4 Low-Density Lipoprotein Cholesterol and Coronary Heart Disease Risk 470

6.20.2.5 Lipoprotein(a) and Coronary Heart Disease Risk 470

6.20.2.6 Markers of Inflammation and Oxidant Stress in Coronary Heart Disease 471

6.20.2.7 High-Density Lipoprotein Cholesterol and Coronary Heart Disease Risk 471

6.20.3 Experimental Disease Models 472

6.20.3.1 Murine Models of Atherosclerosis 472

6.20.3.2 Chronic Models in Higher Species 472

6.20.4 Clinical Trial Issues 472

6.20.4.1 Low-Density Lipoprotein Cholesterol-Lowering Agents 472

6.20.4.1.1 Clinical efficacy of hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins) as low-density lipoprotein cholesterol-lowering agents in patients with coronary heart disease 473

6.20.4.1.2 Safety concerns with statins 476

6.20.4.1.3 Clinical efficacy of cholesterol absorption inhibitors as low-density lipoprotein cholesterol-lowering agents 477

6.20.4.1.4 Combinations of statins and cholesterol absorption inhibitors 477

6.20.4.2 Antioxidants as Monotherapy in Coronary Heart Disease 478 6.20.4.2.1 Antioxidants in combination therapy with statins 478

6.20.4.3 High-Density Lipoprotein Cholesterol-Elevating Agents 478

6.20.4.3.1 Fibrates as high-density lipoprotein cholesterol-elevating agents 479

6.20.4.3.2 Niacin as a high-density lipoprotein cholesterol-elevating agent 479

6.20.4.3.3 Combinations of statins with high-density lipoprotein cholesterol-elevating agents 479

6.20.5 Current Treatments 480 6.20.5.1 Low-Density Lipoprotein Cholesterol-Lowering Agents:

Hydroxymethylglutaryl-Coenzyme A Reductase Inhibitors (Statins) 480

6.20.5.1.1 Mevastatin and lovastatin 480

6.20.5.1.2 Simvastatin 481

6.20.5.1.3 Pravastatin 481

6.20.5.1.4 Atorvastatin 481

6.20.5.1.5 Fluvastatin 482

6.20.5.1.6 Cerivastatin 483

6.20.5.1.7 Rosuvastatin 484

6.20.5.1.8 Pitavastatin 484

6.20.5.2 Low-Density Lipoprotein Cholesterol-Lowering Agents: Cholesterol

Absorption Inhibitors 485

6.20.5.3 Low-Density Lipoprotein Cholesterol-Lowering Agents: Synthetic

Antioxidants 486

6.20.6 Unmet Medical Needs 486

6.20.6.1 Limitations of Low-Density Lipoprotein Cholesterol Reduction and Statin Therapy 486

6.20.6.2 High-Density Lipoprotein Cholesterol-Elevating Agents 486

6.20.7 New Research Areas 487

6.20.7.1 Low-Density Lipoprotein Cholesterol-Lowering Agents 487

6.20.7.1.1 Ileal bile acid transporter (IBAT) and apical sodium-co-dependent bile acid transporter (ASBT) inhibitors 487

6.20.7.1.2 Acyl-CoA:cholesterol acyltransferase inhibitors 487

6.20.7.2 High-Density Lipoprotein Cholesterol-Elevating Agents 487

6.20.7.2.1 Cholesteryl ester transfer protein inhibitors 488

6.20.7.2.2 Peroxisome proliferator-activated receptor agonists 490

6.20.7.3 Anti-Inflammatory Based Approaches 490

6.20.7.3.1 Oral 5-lipoxygenase-activating protein inhibitors 491

6.20.7.3.2 New oral anti-inflammatory antioxidants 491

6.20.8 Conclusions 491 References 492

Your Heart and Nutrition

Your Heart and Nutrition

Prevention is better than a cure. Learn how to cherish your heart by taking the necessary means to keep it pumping healthily and steadily through your life.

Get My Free Ebook


Post a comment