LDL cholesterol
lipoproteinLDL accumulation in the arterial intima is the initiating substrate of atherosclerotic plaque formation.
Pathway placement
Cascade stepLipid retention & oxidation
Confidencehigh
RationaleAnchor molecule; ApoB-lipoprotein retention in intima initiates atherosclerosis.
Druggability
Not assessed (no mapped human gene target).
Type I vs Type II discrimination
ScoresShared / rises in both
R — rupture / Type-I67
C — confounder / Type-II53
A — assay feasibility84
E — evidence strength82
T1DI (composite)39
Specificity differential (R−C)+13.4
Confounder panel (Type-II drivers)
1sepsis / systemic inflammationmag 1
2anemia / acute blood lossn/a
3hypovolemia / dehydrationn/a
4tachyarrhythmiamag 1
5hypoxemia / respiratory failuremag 2
6hypertensive emergencymag 2
7high-demand / peri-operative stressmag 2
Coverage: 5/7 confounders with evidence
Tier: deep-scored (abstract-extracted) · 7 supporting references. See the discrimination table for all markers.
Assay & specimen
Validated clinical assay
Specimen
Serum or plasma (fasting preferred)
Collection tube
Serum separator (gold/red-top, SST) · Lithium heparin (green-top)
Method / principle
Direct enzymatic (homogeneous) or calculated (Friedewald/Martin)
Reagent / substrate
Cholesterol esterase + cholesterol oxidase + peroxidase, Trinder chromogen; selective detergents for LDL
Platform
Automated chemistry analyzer
Turnaround · availability
Routine · Universal
Literature evidence(60)
- Lipoprotein apheresis.Cardiology clinics · 2015 · PMID 25939293 · doi
- Systems Biology Research into Cardiovascular Disease: Contributions of Lipidomics-based Approaches to Biomarker Discovery.Current drug discovery technologies · 2015 · PMID 26135855 · doi
- Hepatic Lipase: a Comprehensive View of its Role on Plasma Lipid and Lipoprotein Metabolism.Journal of atherosclerosis and thrombosis · 2015 · PMID 26194979 · doi
- Atherogenic lipids and macrophage subsets.Current opinion in lipidology · 2015 · PMID 26218415 · doi
- The influence of glucocorticoids on lipid and lipoprotein metabolism and atherosclerosis.South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde · 2014 · PMID 25363050 · doi
- Vinpocetine attenuates lipid accumulation and atherosclerosis formation.Biochemical and biophysical research communications · 2013 · PMID 23583194 · doi
- Unrecognized diabetes and myocardial necrosis: predictors of hyperglycemia in myocardial infarction.Arquivos brasileiros de cardiologia · 2013 · PMID 23598457
- Extended-release niacin/laropiprant improves endothelial function in patients after myocardial infarction.Heart and vessels · 2013 · PMID 23712600 · doi
- High-sensitivity C-reactive protein and atherosclerotic disease: from improved risk prediction to risk-guided therapy.International journal of cardiology · 2013 · PMID 23978367 · doi
- Electronegative LDL: a circulating modified LDL with a role in inflammation.Mediators of inflammation · 2013 · PMID 24062611 · doi
- Integrated proteomic and metabolomic analysis reveals the NADH-mediated TCA cycle and energy metabolism disorders based on a new model of chronic progressive heart failure.Molecular bioSystems · 2013 · PMID 24108264 · doi
- The metabolic and pharmacologic bases for treating atherogenic dyslipidaemia.Best practice & research. Clinical endocrinology & metabolism · 2013 · PMID 24840265 · doi
- Associations between incident ischemic stroke events and stroke and cardiovascular disease-related genome-wide association studies single nucleotide polymorphisms in the Population Architecture Using Genomics and Epidemiology study.Circulation. Cardiovascular genetics · 2012 · PMID 22403240 · doi
- Infections may be causal in the pathogenesis of atherosclerosis.The American journal of the medical sciences · 2012 · PMID 22495581 · doi
- Acrolein-conjugated low-density lipoprotein induces macrophage foam cell formation.Atherosclerosis · 2012 · PMID 23305793 · doi
- [Dyslipidemia and atherosclerosis].Nihon rinsho. Japanese journal of clinical medicine · 2011 · PMID 21226274
- Lipid disorders and their relevance to outcomes in chronic kidney disease.Blood purification · 2011 · PMID 21228589 · doi
- Secreted phospholipase A2, lipoprotein hydrolysis, and atherosclerosis: integration with lipidomics.Analytical and bioanalytical chemistry · 2011 · PMID 21445663 · doi
- Blood sphingolipids in homeostasis and pathobiology.Advances in experimental medicine and biology · 2011 · PMID 21910082 · doi
- Editorial: why inhibition of lipoprotein-associated phospholipase A2 has the potential to improve patient outcomes.Current opinion in cardiology · 2010 · PMID 20485161 · doi
- [Front line of oxidized lipoproteins: role of oxidized lipoproteins in atherogenesis and cardiovascular disease risk].Rinsho byori. The Japanese journal of clinical pathology · 2010 · PMID 20662275
- Reconstituted HDL in acute coronary syndromes.Cardiovascular therapeutics · 2010 · PMID 20840194 · doi
- Circulating oxidized low-density lipoprotein: a biomarker of atherosclerosis and cardiovascular risk?Clinical chemistry and laboratory medicine · 2009 · PMID 19099526 · doi
- Lipoprotein-associated phospholipase A(2) and atherosclerosis.Current opinion in lipidology · 2009 · PMID 19667981 · doi
- Vaccination using oxidized low-density lipoprotein-pulsed dendritic cells reduces atherosclerosis in LDL receptor-deficient mice.Cardiovascular research · 2009 · PMID 19819882 · doi
- Platelet lipoprotein interplay: trigger of foam cell formation and driver of atherosclerosis.Cardiovascular research · 2008 · PMID 18218686 · doi
- Lipoprotein size and susceptibility to atherosclerosis--insights from genetically modified mouse models.Current drug targets · 2008 · PMID 18336235 · doi
- Lipid and lipoprotein profile in women with polycystic ovary syndrome.Canadian journal of physiology and pharmacology · 2008 · PMID 18418429 · doi
- Atherogenesis and the humoral immune response to modified lipoproteins.Atherosclerosis · 2008 · PMID 18513726 · doi
- Lipopolysaccharide associates with pro-atherogenic lipoproteins in periodontitis patients.Innate immunity · 2008 · PMID 18669610 · doi
- Atherosclerosis--an immune disease: The Anitschkov Lecture 2007.Atherosclerosis · 2008 · PMID 18951547 · doi
- Oxidized low-density lipoprotein: a double-edged sword on atherosclerosis.Medical hypotheses · 2007 · PMID 17368957 · doi
- Inflammatory biomarkers and risks of myocardial infarction, stroke, diabetes, and total mortality: implications for longevity.Nutrition reviews · 2007 · PMID 18240558 · doi
- Plasma lipoprotein abnormalities in hemodialysis patients--clinical implications and therapeutic guidelines.Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy · 2006 · PMID 16911182 · doi
- Inflammation and atherosclerosis.Annual review of pathology · 2006 · PMID 18039117 · doi
- Pharmacologic augmentation of high-density lipoproteins: mechanisms of currently available and emerging therapies.Current opinion in cardiology · 2005 · PMID 15956828 · doi
- Dietary antioxidants and paraoxonases against LDL oxidation and atherosclerosis development.Handbook of experimental pharmacology · 2005 · PMID 16596803 · doi
- Aerobic exercise, lipoproteins, and cardiovascular disease: benefits and possible risks.Canadian journal of applied physiology = Revue canadienne de physiologie appliquee · 2004 · PMID 15630151 · doi
- Pathobiology of atherosclerosis--a brief review.Seminars in thrombosis and hemostasis · 2004 · PMID 15630673 · doi
- Prevention of a first myocardial infarction.Journal of clinical pharmacology · 2001 · PMID 11304891 · doi
Showing 40 of 60 linked references.
Clinical trials(6)
- A Multicenter, Open Study To Evaluate The Efficacy Of Ezetimibe 10 Mg Added On Statin Therapy, In Reducing LDL Cholesterol To Target Levels In Patients After Acute Coronary SyndromeNCT00652717 · PHASE4 · COMPLETED · Ezetimibe, simvastatin
- Regulation of Cholesterol Absorption: LDL Cholesterol Response to a Combination of Phytosterols and Ezetimibe (Phyto-3)NCT00863265 · EARLY_PHASE1 · COMPLETED · Ezetimibe, Phytosterols + ezetimibe, Placebo
- Effect of Ezetimibe on Oxidized LDL CholesterolNCT01008345 · PHASE4 · COMPLETED · ezetimibe
- Effect of Anagliptin and Sitagliptin on Low-density Lipoprotein Cholesterol in Patients With Type 2 Diabetes and Cardiovascular Risk Factors: Randomized Controlled TrialNCT02330406 · PHASE4 · COMPLETED · Anagliptin, Sitagliptin
- Statin Intensity, Achieved LDL Cholesterol, and Cardiovascular Outcome in Statin Therapy in Patients With Coronary Artery Disease (Post-hoc Study of TNT Trial)NCT03073863 · PHASE4 · COMPLETED · Atorvastatin
- A Randomized, Multicenter, Open-label Trial Comparing the Effectiveness of Inclisiran to Bempedoic Acid on LDL Cholesterol (LDL-C) Lowering in Participants With Atherosclerotic Cardiovascular Disease (VICTORION-CHALLENGE)NCT06431763 · PHASE4 · COMPLETED · Inclisiran sodium, BPA