Triglyceride-Rich Lipoproteins and Inflammation: Independent and Synergistic Roles in Cardiovascular Disease

Purpose of Review: To summarize novel insights regarding the independent and combined roles of triglyceride-rich lipoprotein elevations and low-grade inflammation in cardiovascular disease. Recent Findings: Emerging evidence suggest that triglyceride-rich lipoproteins are more atherogenic than LDL particles, and that remnant cholesterol drives the association with cardiovascular risk. In contemporary secondary prevention, elevated hsCRP is a stronger predicter of cardiovascular events than LDL cholesterol, while in primary prevention, hsCRP and LDL cholesterol equally predict risk of future cardiovascular disease. Some anti-inflammatory trials do not support the use of colchicine in acute coronary syndrome; however, results from recent meta-analyses strongly support colchicine therapy for secondary cardiovascular prevention. Finally, epidemiological and genetic studies indicate that triglyceride-rich lipoproteins cause vascular inflammation, although both risk factors appear to contribute synergistically to cardiovascular risk. Summary: Triglyceride-rich lipoprotein elevations and low-grade inflammation are important, independent cardiovascular risk factors. More research is needed to further characterize their potential interplay in cardiovascular disease and validate never therapies.