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Pablo Corral: Are Cholesterol and Inflammation Really Equal in Atherosclerosis?

Pablo Corral/LinkedIn

Apr 10, 2026, 14:02

Pablo Corral: Are Cholesterol and Inflammation Really Equal in Atherosclerosis?

Pablo Corral, Pharmacology Professor at FASTA University, Past President of Argentine Lipid Society, shared a post on LinkedIn about a recent article by Rui-Xiang Zeng et al., published in JACC Journals:

“Interesting to see cholesterol and inflammation portrayed as equal partners in atherosclerosis.

The problem is that the evidence is not remotely symmetrical.

For LDL-C lowering we have decades of randomized trials—4S, HPS, PROVE-IT, IMPROVE-IT, FOURIER, ODYSSEY, CLEAR Outcomes—consistently showing that lowering LDLc reduces cardiovascular events.

For anti-inflammatory therapy?

A small handful of trials, modest benefits, and sometimes meaningful safety concerns.

Inflammation matters.

No serious scientist denies that.

But putting cholesterol and inflammation on the same evidentiary level is a bit like calling a tie when one side is supported by a vast body of randomized trial evidence and the other by only limited clinical proof.

LDL isn’t just part of the story.

It’s the only target that has repeatedly proven in randomized trials that moving it changes outcomes.

Evidence first.

Symmetry later.”

Title: Cholesterol-Inflammation Fusion Hypothesis in Atherosclerosis: An Evolving Paradigm in Pathogenesis and Therapy