Papel de los lípidos en la ateroesclerosis

In recent years, it has been shown that the circulating level of particles containing apolipoprotein B, especially low-density lipoproteins (LDLs) and lipoprotein(a), is not a risk factor for cardiovascular disease but is instead a major etiological factor. Indisputable evidence has come from prospective observational studies, Mendelian randomization studies, animal models of arteriosclerosis involving the manipulation of lipid-related genes, human genetic diseases (e.g. monogenic familial hypercholesterolemia and hypercholesterolemia associated with an elevated lipoprotein(a) concentration), and interventional studies with lipid-lowering agents. This article reviews these findings and summarizes current understanding of the principle pathogenic mechanisms that make LDL cholesterol one of the main causes of atherosclerotic cardiovascular disease.