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Infusing Good Cholesterol May Help Unclog Arteries

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WebMD Health News
Reviewed by Louise Chang, MD

Nov. 5, 2012 (Los Angeles) -- An IV infusion of "good" HDL cholesterol seems to rapidly remove cholesterol out of plaque-clogged arteries following a heart attack, a small, early study suggests.

The goal of the new treatment is to reduce the high risk of a second heart attack in people who have had a heart attack.

In the year after a heart attack, about 12% of people have a second heart attack or stroke. And half of them happen in the first month, says researcher Andreas Gille, MD, PhD. Gille is head of clinical and translational science strategy at CSL Limited (which funded the study) in Parkville, Australia.

Standard heart attack medications, such as aspirin and anti-clotting drugs, prevent clotting but don’t eliminate an underlying factor: cholesterol that has built up on artery walls, he says.

HDL removes cholesterol from artery walls, but current HDL-boosting drugs, such as niacin and fibrates, take years to work, according to Gille.

Study Results

Gille and colleagues tested CSL112, an infusible and natural human formulation of apolipoprotein A-1 (ApoA-1), in 57 healthy volunteers.

ApoA-1 is the key protein in HDL particles that transports cholesterol from arteries and other tissues into the liver for disposal. Think of it as a garbage truck: It picks up the debris and disposes of it at the dump.

Following a single infusion of CSL112, researchers looked for signs of cholesterol movement. Over the next two hours:

  • Cholesterol removal from cells rose 164%.
  • Levels of ApoA-1 doubled. In contrast, levels of ApoA-1 only rise about 3% in the four weeks after niacin is given, Gille says.

There were no serious side effects.

Robert Eckel, MD, of the University of Colorado Health Sciences Center, says the strategy "is potentially useful. The question is, how important is it to address HDL levels quickly vs. treating them long-term.

"We still don’t know enough about HDL to know how to modify it to best benefit patients," Eckel says.

The findings were presented here at the American Heart Association’s Scientific Sessions 2012.

The next step is a larger study in which CSL112 will be given as a short series of weekly IV infusions shortly following a heart attack or heart-related chest pain.

These findings were presented at a medical conference. They should be considered preliminary, as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.

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Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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