Atherogenesis involves the aggregation of apob-containing particles due to phospholipids on their surface being realigned by mutases, causing them to stick together.

“so there's a lot of them in there and they're all right next to each other bound to these proteoglycans so it's now believe the next step that happens what's on the surface of all these apob containing particles it's phospholipids the cholesterol and triglycerides are inside these particles there's a little bit of UN ified cholesterol on the surface but these phospholipids are very susceptible to two things one is ultimately going to be oxidation which is a big big role in atherogenesis but the first is there are enzymes called mutases that somehow realign the phospholipids that are on the surface of these particles and when distinct phospholipids are put next to each other these particles have a high Affinity to stick to one another and that's called LDL or apob particle aggregation and that is believed to be the first step”