Novel risk factors for atherosclerosis

In the past several years, evidence has accumulated that factors other than conventional risk factors may contribute to the development of atheroscler osis, Conventional risk factors predict less than one half of future cardio vascular events. Furthermore, conventional risk factors may not have the sa me causal effect in different ethnic groups in whom novel risk factors may have a role. These newer risk factors for atherosclerosis include homocyste ine, fibrinogen, impaired fibrinolysis, increased platelet reactivity, hype rcoagulability, lipoprotein(a), small dense low-density lipoprotein cholest erol, and inflammatory-infectious markers. Identification of other markers associated with an increased risk of atherosclerotic vascular disease may a llow better insight into the pathobiology of atherosclerosis and facilitate the development of preventive and therapeutic measures. In this review, we discuss the evidence associating these factors in the pathogenesis of athe rosclerosis, the mechanism of risk, and the clinical implications of this k nowledge.