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. Author manuscript; available in PMC: 2014 Nov 14.
Published in final edited form as: Circulation. 2013 Jul 2;128(1):72–78. doi: 10.1161/CIRCULATIONAHA.112.000443

Figure 1.

Figure 1

The HDL conundrum in 4 representative datasets. A, A strong epidemiological risk association. Total HDL-C levels exhibit a wellvalidated, robust inverse relationship with cardiovascular risk, even among patients with the same (including lower) LDL levels, as seen in the Framingham Heart Study. B, Encouraging prospects for cardiovascular benefit. In the Coronary Drug Project, niacin significantly decreased mortality at long-term (16-year) follow-up. C, Missing prospective event reduction? In AIM-HIGH, adding niacin to statin-treated cardiovascular disease patients with well-controlled baseline LDL levels had no impact on cardiovascular events despite significant HDL increases. D, Novel strategies, more disappointment? CETP inhibitors, like dalcetrapib, can significantly increase HDL levels, but have yet to show clinical benefit, as seen in Dalcetrapib Outcomes Study (dal-OUTCOMES) (post–acute coronary syndrome trial). AIM-HIGH indicates Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglycerides: Impact on Global Health Outcomes; CAD, coronary artery disease; CETP, cholesteryl ester transfer protein; dal-OUTCOMES, Dalcetrapib Outcomes Study; HDL, high-density lipoprotein; HDL-C, high-density lipoprotein-cholesterol; LDL, low-density lipoprotein; and LDL-C, low-density lipoprotein-cholesterol.