[From cholesterol to lipoprotein particle markers and/or risk factors]

Among the risk factors for atherosclerosis, lipoproteins play a central role, particularly in the development of coronary artery disease. The plasma cholesterol level was the first definite indicator of the risk factor. Thereafter, technical progress has permitted the measurement of the cholesterol fractions, LDL cholesterol which is positively correlated with atherosclerosis, and HDL cholesterol, which is protective. However, the measurement of these fractions in a subject does not permit accurate determination of the risk to the subject. Likewise the measurement of apo A-I and B has brought an improvement in determining the risk factor but is still insufficient. The clarification of new markers would allow better definition of the potential atherogenic risk to a given individual Lp A-I (lipoproteins containing apo A-I but not apo A-II) level is probably an important indicator. Similarly, Lp(a) level is certainly an atherogenic lipoprotein and the apo E phenotype modulates the development of atherosclerosis. All these new markers and others, in the future, will better define the risk for an asymptomatic subject, with regard of atherosclerosis and therefore help to prevent it.