Synthetic Cholesterol Removes Plaque from Coronary Arteries

A new study suggests that five weekly infusions of a synthetic form of high-density lipoprotein-cholesterol (HDL, or “good,” cholesterol) can remove significant amounts of plaque from the arteries.

Approximately 25 to 30 years ago, researchers discovered 40 residents of Northern Italy who appeared perfectly healthy even though they had very low levels of HDL-cholesterol. Ordinarily, such people would have a high risk of heart disease, but these people did not. Intrigued, the researchers discovered that they had a variant in a protein known as apolipoprotein A-I, a component of HDL. This variant was named ApoA-I Milano (Esperion Therapeutics) after the city of Milan, where the initial laboratory work was performed. The company’s investigational treatment consists of a recombinant version of ApoA-I Milano plus a phospholipid.

The traditional therapies for atherosclerosis have focused on lowering levels of low-density lipoprotein-cholesterol (LDL-cholesterol). canadian cialis online

The ApoA-I Milano trial, which was con­ducted from November 2001 to March 2003, enrolled patients with acute coronary syndrome. All of the patients had experienced unstable angina or a heart attack. Patients were assigned to take a placebo, a low dose, or a high dose of intravenous recombinant ApoA-I Milano/phospholipid complex. The study drug was administered as a weekly IV infusion for a total of five weeks.

Patients who received the synthetic protein showed a dramatic decrease in arterial plaques, whereas a comparison group of patients who received saline showed no change.

More testing is needed, because the recent clinical trial was a small study.