A groundbreaking study led by a multi-national team, including key researchers from The Texas Heart Institute (THI), is reshaping our understanding of low-density lipoprotein (LDL) and its role in cardiovascular health. Chu-Huang (Mendel) Chen, MD, PhD, Director of Vascular & Medicinal Research at THI, along with Omer Akyol, MD, PhD, and Huan-Hsing (Hansel) Chiang, have contributed to a major new publication in the European Journal of Clinical Investigation, titled Evolving Concepts of Low-Density Lipoprotein: From Structure to Function. This research challenges the long-standing belief that LDL is simply “bad cholesterol” and highlights its broader physiological functions.

While LDL has traditionally been viewed as a primary driver of atherosclerosis, this study underscores its diverse roles in cellular function, inflammation, and disease progression. The research team at THI, in collaboration with leading experts from institutions in Japan, Switzerland, and Taiwan, found that not all LDL particles contribute equally to cardiovascular risk. Their findings suggest that specific LDL subfractions may be more harmful than others, pointing to the need for a more nuanced approach to cardiovascular treatment.

Despite advancements in cholesterol-lowering therapies such as statins, many patients continue to face significant residual cardiovascular risk. The study highlights additional factors—including inflammation, genetics, diabetes, and environmental influences—that contribute to heart disease. The team emphasizes the importance of monitoring high-sensitivity C-reactive protein (hsCRP) as a critical marker of inflammation-driven cardiovascular risk.

This collaborative effort, includes researchers Tatsuya Sawamura, Shinshu University School of Medicine, Matsumoto, Nagano, Japan, Alexander Akhmedov, University of Zurich, Zurich, Switzerland, Ming-Hsien Tsai, PhD, National Pingtung University of Science and Technology, Pingtung, Taiwan, Akemi Kakino, PhD, Shinshu University School of Medicine, Matsumoto, Nagano, Japan, Simon Kraler, University of Zurich, Zurich, Switzerland, and Thomas F. Lüscher, University of Zurich, Zurich, Switzerland. Their findings showcase the global commitment to refining our understanding of cardiovascular disease. The findings suggest that future therapies should move beyond simply lowering LDL levels to focus on identifying and targeting the most harmful LDL subtypes, paving the way for more precise and personalized cardiovascular treatments.

The Texas Heart Institute remains at the forefront of groundbreaking cardiovascular research, driving discoveries that challenge conventional wisdom and advance heart health worldwide. Congratulations to Dr. Chen and the entire team for their remarkable contributions to this evolving field.

Read the full paper here.