High-Density Lipoprotein Cholesterol Efflux Capacity as a Surrogate Marker for Major Cardiac Adverse Events in Japanese Patients

[See article vol. 28: 696-702] Low cholesterol level in high-density lipoprotein (HDL) particles has been widely believed as an independent risk factor for cardiovascular diseases (CVDs). In contrast, HDL-increasing drugs such as cholesteryl ester transfer protein inhibitors failed to produce favorable outcomes for preventing CVDs. Moreover, it has been recently indicated that high HDL cholesterol (HDL-C) level was associated with CVDs in Japan and with all-cause mortality in other countries. These findings make it difficult to understand the role of HDL despite the extensive knowledge from basic and clinical studies. HDL has several functions, including antiatherosclerotic, anti-inflammatory, and antioxidant effects.