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(Circulation. 2004;109:III-2 – III-7.)
© 2004 American Heart Association, Inc.

Atherosclerosis: Evolving Vascular Biology and Clinical Implications

Atherogenic Lipoprotein Particles in Atherosclerosis

Rafael Carmena, MD; Patrick Duriez, PhD; Jean-Charles Fruchart, PhD

From the Department of Endocrinology and Nutrition (R.C.), Facultad de Medicina y Hospital Clínico Universitario, Valencia, Spain; Faculté de Pharmacie (P.D., J.-C.F.), Université du Droit et de la Santé de Lille 2, and the Département de Recherche sur les Lipoprotéines et l’Athérosclérose, Inserm U545 (P.D., J.-C.F.), Institut Pasteur de Lille, Lille, France.

Correspondence to Professor Jean-Charles Fruchart, Département de Recherche sur les Lipoprotéines et l’Athérosclérose, Inserm U545 - Institut Pasteur, 1 rue du Pr Calmette, BP245 59019 Lille, France. E-mail Jean-Charles.Fruchart{at}pasteur-lille.fr

The importance of low-density lipoprotein (LDL) cholesterol in the development of atherosclerosis has long been recognized, and LDL cholesterol remains the primary target of therapy for the prevention of coronary heart disease. Nevertheless, increasing research attention over the past decade has been devoted to the heterogeneity of LDL particles and the atherogenicity of lipids and lipoproteins other than LDL. Particularly atherogenic forms of LDL include small, dense LDL particles and oxidized LDL. All lipoproteins that contain apolipoprotein B, such as LDL, very-low-density lipoprotein, and intermediate-density lipoprotein, tend to promote atherosclerosis; however, these particles differ in their apolipoprotein and triglyceride content. High levels of plasma triglycerides increase the risk of acute coronary events. Lipoprotein(a) is now considered an independent risk factor in both men and women. Ultimately, better understanding of the roles of these lipid particles and subfractions in the initiation and progression of atherosclerosis may affect treatment decisions.

Key Words: apolipoprotein B • lipoprotein(a) • low-density lipoprotein • triglyceride-rich lipoproteins • triglycerides