Achieving secondary prevention low-density lipoprotein particle concentration goals using lipoprotein
Simon C Mathews1, Jaya Mallidi, Krishnaji Kulkarni
1Department of Medicine, The Johns Hopkins University, Baltimore, Maryland, United States of America.
Plos One
|April 6, 2012
Summary
The total cholesterol to HDL cholesterol ratio <3 and ATP-III very high risk composite targets effectively identify patients meeting LDL particle concentration goals. These simple lipid measures may offer an alternative to advanced testing for secondary prevention.
Area of Science:
- Cardiology
- Lipid Metabolism
- Preventive Medicine
Background:
- Elevated LDL particle concentration (LDL-P) indicates residual cardiovascular risk despite meeting LDL cholesterol goals.
- Assessing various lipid parameters is crucial for optimizing secondary prevention strategies.
Purpose of the Study:
- To evaluate seven lipid parameters for their effectiveness in achieving the LDL-P goal (<1000 nmol/L) in very high-risk secondary prevention patients.
- To identify simple, accessible lipid targets that correlate with optimal LDL-P levels.
Main Methods:
- Lipoprotein particle concentration and cholesterol levels were measured in 148 patients.
- Seven lipid parameters were analyzed for their ability to predict achievement of the LDL-P goal.
Main Results:
- The TC/HDL-C ratio <3 and the ATP-III very high risk composite target (LDL-C<70, non-HDL-C<100, TG<150) were most effective in discriminating patients who met the LDL-P goal.
- Standard secondary prevention targets were also effective but resulted in higher LDL-P levels.
- TG<150 and TG/HDL-C<3 showed some discrimination but exceeded the LDL-P goal.
- LDL density phenotype and HDL-C alone did not significantly discriminate LDL-P goal achievement.
Conclusions:
- A simple composite of ATP-III very high risk lipoprotein cholesterol targets or a TC/HDL-C ratio <3 are effective in identifying patients meeting the LDL-P <1000 nmol/L target.
- These lipid-based targets offer a potential alternative to advanced lipid testing for secondary prevention in clinical practice.
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