Remnants, LDL, and the quantification of lipoprotein-associated risk in atherosclerotic cardiovascular disease (original) (raw)

Packard, Chris J. ORCID: https://orcid.org/0000-0002-2386-9927(2022) Remnants, LDL, and the quantification of lipoprotein-associated risk in atherosclerotic cardiovascular disease.Current Atherosclerosis Reports, 24(3), pp. 133-142. (doi: 10.1007/s11883-022-00994-z) (PMID:35175548)

Abstract

Purpose of Review: Implementation of intensive LDL cholesterol (LDL-C) lowering strategies and recognition of the role of triglyceride-rich lipoproteins (TRL) in atherosclerosis has prompted re-evaluation of the suitability of current lipid profile measurements for future clinical practice. Recent Findings: At low concentrations of LDL-C (< 1.8 mmol/l/70 mg/dl), the Friedewald equation yields estimates with substantial negative bias. New equations provide a more accurate means of calculating LDL-C. Recent reports indicate that the increase in risk per unit increment in TRL/remnant cholesterol may be greater than that of LDL-C. Hence, specific measurement of TRL/remnant cholesterol may be of importance in determining risk. Non-HDL cholesterol and plasma apolipoprotein B have been shown in discordancy analyses to identify individuals at high risk even when LDL-C is low. Summary: There is a need to adopt updated methods for determining LDL-C and to develop better biomarkers that more accurately reflect the abundance of TRL remnant particles.

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