─ 217 ─ I. IntroductionLowering low-density lipoprotein cholesterol (LDL-C) is a cornerstone in the current therapeutic guideline to prevent atherosclerotic cardiovascular diseases 1, 2) . This is because numerous large-scale randomized controlled trials have consistently demonstrated the beneficial effect of lowering LDL-C level with a statin for the primary and secondary prevention [3][4][5][6][7][8] . Furthermore, serial intravascular imaging studies have also supported its anti-atherosclerotic effects. Intensive lowering LDL-C has been shown to slow plaque progression and induce its regression if very low LDL-C level is achieved [9][10][11] . However, substantial amount of cardiovascular events still occurs even under intensive control of LDL-C level 12, 13) . The residual cardiovascular risks indicate the need to modulate additional therapeutic targets to further reduce atherosclerotic cardiovascular events.The development and propagation of atherosclerosis is derived by the retention of cholesterol-rich lipoproteins within the subendothelial matrix of the arterial wall. While LDL has been considered as the main atherogenic cholesterol-rich particle, other apolipoprotein-B-containing lipoproteins also contribute to intimal cholesterol deposition. Triglyceride-rich lipoprotein is one of atherogenic particles potentially promoting formation and progression of atherosclerotic plaques 14) . In contrast to these lipoproteins, high-density lipoprotein harbours a variety of atheroprotetcive properties which may have the ability in halting ath- anti-atherosclerotic therapies [9][10][11][16][17][18][19][20] . This review summarizes evidences from clinical and intravascular imaging studies to elucidate the contribution of triglyceride and HDL to atherosclerotic cardiovascular disease (ASCVD) and clinical impact of their modulation. II. TriglycerideTriglyceride exists in plasma as lipoprotein, pseudo lipid-protein complex. Apolipoprotein B is a component of triglycer- Residual cardiovascular risks under statin therapy suggest the need to develop additional therapeutic approach to further improve cardiovascular outcomes. Epidemiological and intravascular imaging studies have revealed the relationship of these lipid targets with atherosclerotic cardiovascular disease, indicating triglyceride and high-density lipoprotein cholesterol (HDL-C) as potential targets for achieving better clinical outcomes. However, clinical efficacy of lowering triglyceride and raising HDL-C level has not been established yet. Although findings from clinical trials testing novel agents targeting these lipid markers are disappointing, further search still continues to identify effective therapeutic approach due to their anti-or pro-atherogenic properties. Intravascular imaging modality has contributed to the elucidation of disease mechanism and the evaluation of novel drugs modulating triglyceride and HDL-C. In this review, anti-or pro-atherogenic properties of triglyceride and HDL-C, its association with clinical outcomes and atheroscle...
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