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Rethinking Lipid Burden and the Role of Non-LDL Biomarkers in Stroke Risk Stratification
Sean Michael Kelly1,2,3, Julia Schneider4,5,6, Michela Rosso4,5,6
1New York University Grossman School of Medicine, New York, United States. sean.kelly2@nyulangone.org.
Non-low-density lipoprotein-cholesterol (LDL-C) biomarkers improve atherosclerotic cardiovascular disease risk assessment. Additional lipid measures like triglyceride-to-high density lipoprotein ratio (TG:HDL), lipoprotein (a) (Lp(a)), and apolipoprotein B (ApoB) aid in stroke risk stratification and secondary prevention.
Area of Science:
- Cardiovascular Medicine
- Lipidology
- Neurology
Background:
- Established link between elevated low-density lipoprotein-cholesterol (LDL-C) and atherosclerosis.
- Growing evidence suggests non-LDL-C biomarkers offer more precise cardiovascular disease (CVD) risk stratification.
Purpose of the Study:
- Review literature on non-LDL biomarkers in atherosclerotic cardiovascular disease (ACSVD).
- Examine their role in atherogenesis and ischemic stroke risk.
- Discuss future applications in secondary stroke prevention.
Main Methods:
- Literature review of existing studies on non-LDL biomarkers.
- Analysis of lipid panel components and additional lipoprotein assays.
- Evaluation of their association with atherosclerosis and stroke risk.
Main Results:
- Non-traditional markers, beyond LDL-C, refine CVD risk assessment.
- Measures like triglyceride-to-high density lipoprotein ratio (TG:HDL), lipoprotein (a) (Lp(a)), and apolipoprotein B (ApoB) are important.
- These markers help estimate metabolic health and atherogenic particle burden.
Conclusions:
- Non-LDL biomarkers are crucial for comprehensive stroke risk assessment.
- Consideration of TG:HDL, Lp(a), and ApoB is recommended for monitoring and secondary stroke prevention.
- Further research is needed to fully define their role in ischemic stroke risk.
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