What happens to cholesterol efflux after an AMI?

In the days following an AMI, cholesterol efflux remains reduced and is significantly reduced in those with inflammation. It can take a month to recover to the level at the time of the AMI.1–3

In the dalACUTE study, 300 patients were randomized to dalcetrapib – a cholesteryl ester transfer protein inhibitor – 600 mg/day or placebo within 1 week following an acute coronary syndrome. Change in cholesterol efflux was more strongly correlated with changes in ApoA-I and HDL cholesterol.1

Adapted from Ray et al. 20141

Why the 90-day high-risk period is important

The 90-day period after an AMI is emerging as an important window for acute, high-risk recurrent CV events.4,5


During the first 90 days after an AMI, the incidence of hospitalization is disproportionately high. Nearly a third of patients hospitalized for AMI are readmitted with a recurrent CV event within 90 days of their AMI.5,6–9

90-day endpoints are critical and clinically relevant.4,5

Several studies have confirmed a strong link between low cholesterol efflux and a greater risk of recurrent CV events, so additional therapeutic options during this high-risk period should be explored.1,2,10–15

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Burden of recurrent CV events

Find out about the significant healthcare costs associated with recurrent CV events post AMI16–19

Current standard of care post AMI

Current standard of care and newer therapies have lowered the long-term risk of recurrent CV events; however, data show that patients are still at risk during the 90-day high-risk period after an AMI20–27

Expert views

These resources are for healthcare professionals to learn more about the role of cholesterol efflux and support their patients after an AMI

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AMI, acute myocardial infarction; ApoA-I, apolipoprotein A-I; CV, cardiovascular; HDL, high-density lipoprotein


1. Ray KK et al. Eur Heart J 2014; 35:1792–1800.

2. Soares AAS et al. Clin Chim Acta 2018; 478:51–56.

3. Gille A et al. Circulation 2017; 136:A16500.

4. Chi G et al. Clin Cardiol 2022; 45:299–307.

5. Vora AN et al. Circ Cardiovasc Qual Outcomes 2016; 9:513–522.

6. Khera R et al. Am J Cardiol 2017; 120:1761–1767.

7. Kini V et al. Circ Cardiovasc Qual Outcomes 2018; 11:e004788.

8. Chen H-Y et al. Am J Cardiol 2016; 117:743–748.

9. Allen K et al. Circulation 2020; 142:A12546.

10. Zhang J et al. Am J Cardiol 2016; 117:508–514.

11. Liu C et al. Atherosclerosis 2016; 249:116–124.

12. Saleheen D et al. Lancet Diabetes Endocrinol 2015; 3:507–513.

13. Shao B et al. Circ Res 2014; 114:1733–1742.

14. Rohatgi A et al. N Engl J Med 2014; 371:2383–2393.

15. Guerin M et al. J Am Coll Cardiol 2018; 72:3259–3269.

16. Bakhai A et al. J Interv Cardiol 2012; 25:19–27.

17. Punekar RS et al. Clin Cardiol 2015; 38:483–491.

18. Zhao Z, Winget M. BMC Health Serv Res 2011; 11:35.

19. Chapman RH et al. BMC Cardiovasc Disord 2011; 11:11.

20. Schwartz GG et al. N Engl J Med 2018; 379:2097–2107.

21. Cannon CP et al. N Engl J Med 2015; 372:2387–2397.

22. Schwartz GG et al. JAMA 2001; 285:1711–1718.

23. Bhatt DL et al. N Engl J Med 2019; 380:11–22.

24. Bhatt DL et al. J Am Coll Cardiol 2019; 73:2791–2802.

25. Mehta SR et al. N Engl J Med 2019; 381:1411–1421.

26. Wallentin L et al. N Engl J Med 2009; 361:1045–1057.

27. Nair R et al. J Am Heart Assoc 2021; 10:e019270.

USA-GEN-0051 | August 2023