Lipoproteins and diabetes.

Abstract

Ever since the French–German pathologist Jean Lobstein coined the term arteriosclerosis in 1833,1 the disease has been intensively investigated. In 1793, Edward Jenner, later a celebrity for his contribution to small pox vaccination, performed an autopsy on his colleague John Hutner who had died suddenly during a heated discussion at a board meeting at St Georges Hospital in London. In his notes he wrote: ‘I found no material disease of the heart, except that the coronary arteries were thickened’.2 Rudolf Virchow was the first to recognize the inflammatory nature of atherosclerosis and the role of lipids therein,3 a concept that is still stands true today.4 It was a Russian military physician, however, who—behind the Iron Curtain in 1913—proved the concept by feeding rabbits with a high-fat diet. With his experiment, Nikolai N. Anichkov showed that lipid-rich plaques had developed under these circumstances in the aorta of the animals.5 Once the Framingham study confirmed the importance of high cholesterol for the development of myocardial infarction, stroke, and death in US and European populations,6 cholesterol became a therapeutic target. Thanks to the discovery of Akiro Endo,7 statins, together with antihypertensive drugs and aspirin, became a cornerstone in cardiovascular prevention8 and contributed to the rise of cardiovascular medicine.9 Today, LDL cholesterol (LDL-C) and statins are used extensively in clinical practice and are part of several guidelines of the European Society of Cardiology in individuals at risk10,11 and patients with established coronary artery disease.12 The current issue of the European Heart Journal focuses on lipoproteins and diabetes. In spite of all the progress made, several aspects of lipids in cardiovascular disease remain unresolved, in …