Remnant lipoprotein particles and cardiovascular disease risk

Intravascular catabolism of chylomicrons and very low-density li-poproteins (VLDLs) gives rise to a spectrum of partially lipolyzed remnant particles. Their plasma levels and properties are influ-enced by lipases, lipid transfer proteins, and content of exchangeable lipoproteins. Particularly important among the latter are apoE, which mediates hepatic binding and uptake of remnants, and apoCIII, which can retard this process. In the course of their plasma transit, remnants can acquire pathologic properties that promote the development of atherosclerotic cardiovascular disease (ASCVD) including increased cholesterol content and transport of thrombogenic and inflammatory mediators. Levels of cholesterol -enriched remnant particles determined by various analytic tech-niques have been significantly linked to the incidence of ASCVD, most dramatically in dyslipidemic patients homozygous for the apoE2 genetic isoform. Further research is warranted for devel-opment of clinical assays that can better capture the pathologic impact of remnant lipoprotein subspecies, and for testing the impact on ASCVD of therapies that reduce their levels.(c) 2022 Published by Elsevier Ltd.