REVIEW article
Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1576602
This article is part of the Research TopicScreening Remnant Lipid Markers in Cardiometabolic DiseasesView all 12 articles
Non-Traditional Lipid Biomarkers in Atherosclerotic Cardiovascular Disease: Pathophysiological Mechanisms and Strategies to Address Residual Risk
Provisionally accepted
Cong Wang1Haifeng Fu1Hao Xu1Handong Yang1Xinwen Min1
Wenwen Wu2
Zhixin LIU3Dongfeng Li1Yun Dong1
Jun Chen1*- 1Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, China
- 2College of Public Health, Hubei University of Medicine, Shiyan, China
- 3Shiyan Key Laboratory of Virology, Hubei University of Medicine, Shiyan, China
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Atherosclerotic cardiovascular disease (ASCVD) pathogenesis is fundamentally driven by dyslipidemia, characterized by lipid metabolism disorders that facilitate cholesterol deposition within damaged vascular endothelia. This process culminates in atherosclerotic plaque formation and coronary stenosis, ultimately inducing myocardial ischemia. While low-density lipoprotein cholesterol (LDL-C) remains the principal lipid determinant of ASCVD progression, emerging evidence indicates persistent residual cardiovascular risk despite optimal statin-mediated LDL-C control. This review aims to systematically evaluate the contributory role of non-traditional lipid biomarkers in ASCVD pathophysiology and clinical outcomes. Through comprehensive analysis of current research, we examine the biological properties and atherogenic mechanisms of non-conventional lipid particles, epidemiological evidence linking these biomarkers with residual cardiovascular risk, and therapeutic implications of targeting alternative lipid pathways. Particular emphasis is placed on elucidating the pathophysiological interplay between triglyceride-rich lipoproteins, lipoprotein(a), and oxidized phospholipids with vascular inflammation and plaque instability. Furthermore, we critically appraise recent clinical trial data regarding novel lipid-modifying agents and propose future research directions to address current knowledge gaps in residual risk management. This synthesis underscores the necessity of expanding therapeutic strategies beyond LDL-C reduction to achieve comprehensive cardiovascular risk mitigation. Keywor d ： atherosclerosis ； cardiovascular disease ； residual risk ； blood lipid ； biomarkers
Keywords: Atherosclerosis, cardiovascular disease, Residual Risk, Blood lipid, biomarkers
Received: 14 Feb 2025; Accepted: 20 Jun 2025.
Copyright: © 2025 Wang, Fu, Xu, Yang, Min, Wu, LIU, Li, Dong and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jun Chen, Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, China
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