The endotoxin-lipoprotein hypothesis

Mathias Rauchhaus, Andrew J S Coats, Stefan D. Anker

Research output: Contribution to journalArticle

413 Citations (Scopus)

Abstract

The advent of 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) has revolutionised the treatment of hypercholesterolaemia. Statin treatment, by lowering the atherogenic lipoprotein profile, reduces morbidity and mortality in patients with cardiovascular disease. Treatment with simvastatin causes a reduction of events of new-onset heart failure, but this may be attributable to properties other than its lipid-lowering effects. There is some evidence that lower serum cholesterol concentrations (as a surrogate for the totality of lipoproteins) relate to impaired survival in patients with chronic heart failure (CHF). Inflammation is a feature in patients with CHF and increased lipopolysaccharide may contribute substantially. We postulate that higher concentrations of total cholesterol are beneficial in these patients. This is potentially attributable to the property of lipoproteins to bind lipopolysaccharide, thereby preventing its detrimental effects. We hypothesise there is an optimum lipoprotein concentration below which lipid reduction would, on balance, be detrimental. We also propose that, in patients with CHF, a non-lipid-lowering statin (with anciilary properties such as immune modulatory and anti-inflammatory actions) could be as effective or even more beneficial than a lipid-lowering statin.

Original languageEnglish
Pages (from-to)930-933
Number of pages4
JournalLancet
Volume356
Issue number9233
Publication statusPublished - Sep 9 2000

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Endotoxins
Lipoproteins
Heart Failure
Lipids
Lipopolysaccharides
Cholesterol
Simvastatin
Hypercholesterolemia
Oxidoreductases
Anti-Inflammatory Agents
Cardiovascular Diseases
Therapeutics
Inflammation
Morbidity
Survival
Mortality
Serum

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Rauchhaus, M., Coats, A. J. S., & Anker, S. D. (2000). The endotoxin-lipoprotein hypothesis. Lancet, 356(9233), 930-933.

The endotoxin-lipoprotein hypothesis. / Rauchhaus, Mathias; Coats, Andrew J S; Anker, Stefan D.

In: Lancet, Vol. 356, No. 9233, 09.09.2000, p. 930-933.

Research output: Contribution to journalArticle

Rauchhaus, M, Coats, AJS & Anker, SD 2000, 'The endotoxin-lipoprotein hypothesis', Lancet, vol. 356, no. 9233, pp. 930-933.
Rauchhaus M, Coats AJS, Anker SD. The endotoxin-lipoprotein hypothesis. Lancet. 2000 Sep 9;356(9233):930-933.
Rauchhaus, Mathias ; Coats, Andrew J S ; Anker, Stefan D. / The endotoxin-lipoprotein hypothesis. In: Lancet. 2000 ; Vol. 356, No. 9233. pp. 930-933.
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