Atherosclerosis is a progressive inflammatory thickening of the arterial wall
resulting from increased cellularity and the accumulation of lipids, cellular debris, and
extracellular matrix. Conventional determinations of plasma lipoproteins have resulted
in a wealth of clinical data documenting the correlation between low- and high-density
lipoproteins (LDL and HDL) and cardiovascular disease (CVD) risk. Current mass
spectrometry methodologies allow the detection and quantification of multiple molecular lipid species
with various structural and functional roles. The opportunities provided by lipidomics for lipid-based
biomarker discovery are prominent in disease diagnostics, monitoring of drug efficacy, and translational
model development. For example, the analysis of human plasma samples assessing the effects of statins
has shown correlative effects between the LDL/HDL ratio and sphingomyelin and phosphatidylcholine.
Additionally, at the vascular tissue level, lipids from different classes are enriched in human plaques of
coronary arteries and in the aortas of apolipoprotein E-deficient mice exposed to cigarette smoke,
highlighting a set of lipid biomarkers for translational research. Molecular lipidomics will provide
insights in which other lipids may play important roles in vascular disease progression and will serve as
novel markers for preventive as well as therapeutic purposes.