**Acknowledgements**

During inflammation, the blood vessel produces large amounts of PTX3; its high level in circulation related with pathological conditions affects cardiovascular system. Recently, epidemiological and clinical data showed that PTX3 is a valid biomarker for atherosclerosis [72] and its high plasma levels were found to be related with the severity of coronary atherosclerosis [34]. It has been demonstrated that PTX3 increases the tissue factor (TF) expression in mononuclear and endothelial cells. The increased level of TF activates the coagulation cascade and causes the thrombus formation [73]. PTX3 might also bind to growth factor 2 (FGF2) and interfere with plaque stability via effect of the proliferation and migration of smooth muscle cells [74]. Based on such findings, PTX3 is more specific for coronary plaque instability than for atherosclerosis. In addition, the elevated plasma level of PTX3 has been found in patients with high systolic and diastolic blood pressure levels [75]. On the other hand, in patients with acute myocardial infarction, PTX3 was shown to be produced by the neutrophils penetrating into unstable coronary plaques. This underscored the fact that PTX3 might be more accurate predictor of cardio-

As conclusion, it is well known that atherosclerosis is a chronic inflammatory disease of the vessel wall. This chapter reviewed the relationship between atherosclerosis and the various effects of different inflammatory biomarkers and possible roles of genetic predisposition on the development and progression of coronary artery diseases (**Figure 4**). Atherosclerotic disease mostly starts

**Figure 4.** Inflammatory markers secreted from various cells in atherosclerotic lesion. Pro-inflammatory markers such as cytokines, pentraxin-3, MMPs, and LOX-1 are produced by macrophages, endothelial cells, and vascular smooth muscle cells in atherosclerotic lesion. CRP is mainly produced in the liver stimulated by IL-6. CRP indicates C-reactive protein; IL-6, interleukin-6; LDL, low-density lipoprotein; LOX-1, lectin-like oxidized LDL receptor-1; and MMP, matrix

metalloproteinase.

vascular events after myocardial infarction than other markers [76].

66 Cholesterol - Good, Bad and the Heart

The author would like to thank Zeynep Erdem and Berna Kavas for reviewing the English of this chapter and Gizem Ozturk for drawing the figures.
