Associations of ABCG1-mediated cholesterol efflux capacity with coronary artery lipid content assessed by near-infrared spectroscopy

Epidemiological studies have found inverse associations between high-density lipoprotein cholesterol (HDL-C) and atherosclerotic cardiovascular disease (ASCVD) risk (1). Nonetheless, HDL-C-raising clinical trials have largely shown no benefit on cardiovascular outcome (1). Recent population-based studies have reported that extremely high HDL-C levels were associated with high cardiovascular mortality (2). Furthermore, genetic evidence has also demonstrated that changes in alleles that lead to high HDL-C levels do not associate with the risk of myocardial infarction (3). These inconsistent findings have led to a shift in focus from HDL-C concentrations to HDL functionality as a novel target for preventing ASCVD