Increased concentrations of high-density lipoprotein (HDL) cholesterol have been closely associated with decreased risk of future cardiovascular disease. This protective effect of HDL has been mainly attributed to its involvement in reverse cholesterol transport. More recently, it has been suggested that apolipoprotein A-I (apoA-I), the major protein component of HDL, possesses nearly identical information as HDL in terms of risk prediction for future cardiovascular disease. This makes apoA-I a very attractive biomarker candidate for implementation into clinical practice, taking into account its analytical advantages. This review summarizes our current knowledge based on observations from recent studies, with emphasis on potential pathophysiologic mechanisms of action and on the clinical utility of apoA-I as a predictor of cardiovascular risk.
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