Non-high-density lipoprotein cholesterol: current status as cardiovascular marker

Area of Science:

• Cardiology
• Lipidology
• Preventive Medicine

Background:

• Cardiovascular disease (CVD) remains a leading cause of mortality worldwide.
• Accurate risk stratification is crucial for effective CVD prevention strategies.
• Lipid profiles, including various cholesterol fractions, are central to CVD risk assessment.

Purpose of the Study:

• To review the evidence supporting non-high density lipoprotein cholesterol (non-HDL-C) as a cardiovascular disease (CVD) risk factor.
• To compare the predictive value of non-HDL-C against low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apoB).

Main Methods:

• Systematic review of existing literature on non-HDL-C, LDL-C, and apoB in CVD risk.
• Analysis of data published within the last 18 months regarding non-HDL-C.
• Evaluation of current clinical guidelines and expert opinions.

Main Results:

• Non-HDL-C is recognized as a co-primary target for lipid management, alongside LDL-C, according to the 2015 National Lipid Association Annual Summary.
• Recent data published over the past 18 months consistently support previous findings on non-HDL-C.
• No new evidence has emerged that contradicts the established role of non-HDL-C in predicting CVD.

Conclusions:

• The cumulative evidence strongly indicates that non-HDL-C offers superior performance in estimating cardiovascular disease risk compared to LDL-C alone.
• Non-HDL-C should be considered a primary target in clinical practice for comprehensive CVD risk assessment.