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Should we change our lipid management strategies to focus on non-high-density lipoprotein cholesterol?
MedLine Citation:
PMID:  20852414     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Despite aggressive low-density lipoprotein cholesterol lowering, patients continue to be at significant risk of cardiovascular events. Assessment of non-high-density lipoprotein cholesterol (non-HDL-C) provides a measure of cholesterol contained in all atherogenic particles. In the third Adult Treatment Panel guidelines, non-HDL-C was introduced as a secondary target of therapy.
RECENT FINDINGS: A combined post-hoc analysis of data from two prospective, randomized trials assessing the role of statins in patients with established coronary heart disease showed that on-treatment levels of non-HDL-C were more closely associated with cardiovascular outcomes than levels of low-density lipoprotein cholesterol. A recent meta-analysis of the relationship between non-HDL-C reduction and coronary heart disease risk showed that most lipid-modifying drugs used as monotherapy have a 1 : 1 relationship between percentage non-HDL-C lowering and percentage coronary heart disease reduction. In the European Prospective Investigation Into Cancer and Nutrition-Norfolk prospective population study (n = 21,448), participants with high non-HDL-C levels were at increased coronary heart disease risk independently of their low-density lipoprotein cholesterol levels.
SUMMARY: Because non-HDL-C appears to be superior for risk prediction beyond low-density lipoprotein cholesterol, future guidelines should emphasize the importance of non-HDL-C for guiding cardiovascular prevention strategies. There is an increased need to have non-HDL-C reported on routine lipid panels, especially because it would be at no added cost.
Authors:
Jamal S Rana; S Matthijs Boekholdt
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current opinion in cardiology     Volume:  25     ISSN:  1531-7080     ISO Abbreviation:  Curr. Opin. Cardiol.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8608087     Medline TA:  Curr Opin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  622-6     Citation Subset:  IM    
Affiliation:
Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, California, USA. jamal.rana@cshs.org
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