JACC Associate Editor Marc P. Bonaca, MD, FACC, has a discussion with author Sotirios Tsimikas, MD, FACC about this study on phospholipids presented at AHA and published in JACC. In MESA, both OxPL-apoB and Lp(a) were independently associated with prevalent AVC with a significant interaction between the two (p less than 0.01). OxPL-apoB and Lp(a) were associated with incident AVC at 9.5 years when evaluated independently (interaction p less than 0.01). The OxPL-apoB*Lp(a) interaction demonstrated higher odds of prevalent and incident AVC for OxPL-apoB with increasing Lp(a) levels. In the meta-analysis, both OxPL-apoB and Lp(a) were independently associated with faster increase in Vmax, but when evaluated together, only OxPL-apoB remained significant. OxPL-apoB is an independent predictor of the presence, incidence and progression of AVC and established AS and represents a novel therapeutic target for CAVD.