Lipids and atherosclerosis

Lipids play a pivotal role in the atherogenesis, starting from initial changes. Their predictive value in coronary heart disease and development of novel therapeutic strategies is an increasingly addressed issue nowadays. LDL particles are fundamental, because reduction of LDL-cholesterol was proven to reduce morbidity and mortality associated with atherosclerosis. Besides the regulation of LDL-receptor expression, significant clinical importance is assigned to oxidized LDL (ox-LDL) and small dense LDL (sdLDL) that are generated through intravascular remodeling of triglyceride-rich lipoproteins, while the exact role of anti-oxLDL antibodies in atherosclerosis propagation and their clinical significance still remain unclear. In recent years, however, better understanding of the basic mechanisms involved in atherosclerosis development, as well as in the metabolic fate of lipids and lipoproteins, emphasizes the crucial role of other lipoprotein particles not only in the propagation, but also in the initiation of atherosclerosis and atherothrombosis.