Youmna Ghaleb, Sandy Elbitar, Anne Philippi, Petra El Khoury, Yara Azar, Miangaly Andrianirina, Alexia Loste, Yara Abou-Khalil, Gaël Nicolas, Marie Le Borgne, Philippe Moulin, Mathilde Di-Filippo, Sybil Charrière, Michel Farnier, Cécile Yelnick, Valérie Carreau, Jean Ferrières, Jean-Michel Lecerf, Alexa Derksen, Geneviève Bernard, Marie-Soleil Gauthier, Benoit Coulombe, Dieter Lütjohann, Bertrand Fin, Anne Boland, Robert Olaso, Jean-François Deleuze, Jean-Pierre Rabès, Catherine Boileau, Marianne Abifadel, Mathilde Varret, Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Université Saint-Joseph de Beyrouth (USJ), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Physiopathologie et épidémiologie cérébro-cardiovasculaire [Dijon] (PEC2), Université de Bourgogne (UB)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 (RID-AGE), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Lille, Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre d'Epidémiologie et de Recherche en santé des POPulations (CERPOP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Réseau International des Instituts Pasteur (RIIP), McGill University Health Center [Montreal] (MUHC), Institut de Recherches Cliniques de Montréal (IRCM), Université de Montréal (UdeM), McGill University = Université McGill [Montréal, Canada], University Hospital Bonn, Centre National de Recherche en Génomique Humaine (CNRGH), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Laboratory of Excellence GENMED [Paris] (Medical Genomics), Centre d'Etude du Polymorphisme Humain (CEPH), Institut Universitaire d'Hématologie (IUH), Université Paris Diderot - Paris 7 (UPD7)-Université Paris Diderot - Paris 7 (UPD7)-Fondation Jean Dausset-Université Paris Cité (UPCité), Hôpital Ambroise Paré [AP-HP], Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), PCSK9013, 13CVD03, ANR-10-LABX-0013, National Institutes of Health, NIH: BB-033-00065, R01 HL107816, Broad Institute, International Atherosclerosis Society, IAS, Canadian Institutes of Health Research, IRSC: 2017–2022, Fonds de Recherche du Québec - Santé, FRQS, Agence Nationale de la Recherche, ANR: ANR-16-RHUS-0007, Fondation Leducq, Institut National de la Santé et de la Recherche Médicale, Inserm, Conseil National de la Recherche Scientifique, CNRS, This work was supported by grants from the Leducq Foundation (FLQ # 13CVD03), the Laboratory of Excellence GENMED (Medical Genomics) grant no. ANR-10-LABX-0013 managed by the National Research Agency (ANR), part of the Investment for the Future program, and the National Project CHOPIN (Cholesterol Personalized Innovation) granted by the National Research Agency (ANR-16-RHUS-0007), INSERM (Institut National de la Sant? et de la Recherche M?dicale). Youmna Ghaleb is supported by a grant from the Lefoulon-Delalande Foundation and the International Atherosclerosis Society (IAS). Yara Azar and Yara Abou-Khalil are supported by grants from the Lebanese National Council for Scientific Research (CNRS-L) and the Council of Research of Saint-Joseph University of Beirut, Lebanon, Yara Azar is supported by a grant from AMGEN funding (PCSK9013). Yara Abou-Khalil is supported by a grant from Minist?re de l?Education Nationale et de la Technologie (France) and a grant from Nouvelle Soci?t? Francophone de l?Ath?roscl?rose (France). Genevi?ve Bernard received a Research Scholar Junior 1 award from the Fonds de Recherche du Qu?bec?Sant? (FRQS) (2012?2016) and the New Investigator Salary Award from the Canadian Institutes of Health Research (2017?2022). Acknowledgments: We thank all family members and the proband cohort for participating in the study. We thank Sekar Kathiresan, Gina Peloso and Nathan Stitziel (Broad Institute of MIT, Boston, MA, USA) for their help in the exome sequencing experiments. Sekar Kathiresan was supported by NIH R01 HL107816. We acknowledge the use of the bioresources of the Necker DNA Biobank (BB-033-00065). We thank Silvia Friedrichs for the technical assistance in sterol and bile acid analyses by GC-MS., Funding: This work was supported by grants from the Leducq Foundation (FLQ # 13CVD03), the Laboratory of Excellence GENMED (Medical Genomics) grant no. ANR-10-LABX-0013 managed by the National Research Agency (ANR), part of the Investment for the Future program, and the National Project CHOPIN (Cholesterol Personalized Innovation) granted by the National Research Agency (ANR-16-RHUS-0007), INSERM (Institut National de la Santé et de la Recherche Médicale). Youmna Ghaleb is supported by a grant from the Lefoulon-Delalande Foundation and the International Atherosclerosis Society (IAS). Yara Azar and Yara Abou-Khalil are supported by grants from the Lebanese National Council for Scientific Research (CNRS-L) and the Council of Research of Saint-Joseph University of Beirut, Lebanon, Yara Azar is supported by a grant from AMGEN funding (PCSK9013). Yara Abou-Khalil is supported by a grant from Ministère de l’Education Nationale et de la Technologie (France) and a grant from Nouvelle Société Francophone de l’Athérosclérose (France). Geneviève Bernard received a Research Scholar Junior 1 award from the Fonds de Recherche du Québec—Santé (FRQS) (2012–2016) and the New Investigator Salary Award from the Canadian Institutes of Health Research (2017–2022)., Acknowledgments: We thank all family members and the proband cohort for participating in the study. We thank Sekar Kathiresan, Gina Peloso and Nathan Stitziel (Broad Institute of MIT, Boston, MA, USA) for their help in the exome sequencing experiments. Sekar Kathiresan was supported by NIH R01 HL107816. We acknowledge the use of the bioresources of the Necker DNA Biobank (BB-033-00065). We thank Silvia Friedrichs for the technical assistance in sterol and bile acid analyses by GC-MS., HAL UVSQ, Équipe, Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), and ANR-16-RHUS-0007,CHOPIN,CHOPIN(2016)