Beyond low-density lipoprotein cholesterol. A perspective on low high-density lipoprotein disorders and Lp(a)...

Area of Science:

• Cardiology
• Lipidology
• Preventive Medicine

Background:

• Coronary heart disease (CHD) is a significant health concern.
• Low high-density lipoprotein (HDL) disorders and elevated lipoprotein(a) [Lp(a)] are common dyslipidemias implicated in CHD.
• Current management strategies for these specific dyslipidemias in relation to CHD prevention require further refinement.

Purpose of the Study:

• To review the evidence linking low HDL and Lp(a) excess to coronary heart disease.
• To propose interim management strategies for these dyslipidemias.
• To identify patient groups at high risk for premature coronary heart disease.

Main Methods:

• Literature review of evidence supporting the role of low HDL and Lp(a) in CHD.
• Analysis of current cholesterol-lowering guidelines for applicability.
• Formulation of suggested empiric treatment guidelines.

Main Results:

• Low HDL and Lp(a) excess are established risk factors for coronary heart disease.
• Cholesterol-lowering guidelines offer a framework for managing low HDL disorders.
• Identification of high-risk patient subgroups is feasible with current guidelines.

Conclusions:

• Empiric treatment guidelines for low HDL disorders and Lp(a) excess are proposed.
• These guidelines aim to manage current risk and foster discussion for future clinical validation.
• Further clinical trial data is essential to confirm the efficacy of specific interventions.