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Residual Atherosclerotic Cardiovascular Disease Risk: Focus on Non-High-Density Lipoprotein Cholesterol.

作者信息

Luo Yonghong, Peng Daoquan

机构信息

Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China.

出版信息

J Cardiovasc Pharmacol Ther. 2023 Jan-Dec;28:10742484231189597. doi: 10.1177/10742484231189597.


DOI:10.1177/10742484231189597
PMID:37641208
Abstract

Cardiovascular disease (CVD) caused by atherosclerosis is the leading cause of death worldwide. The level of low-density lipoprotein cholesterol (LDL-C), considered as the initiator of atherosclerosis, is the most widely used predictor for CVD risk and LDL-C has been the primary target for lipid-lowering therapies. However, residual CVD risk remains high even with very low levels of LDL-C. This residual CVD risk may be due to remnant cholesterol, high triglyceride levels, and low high-density lipoprotein cholesterol (HDL-C). Non-high density lipoprotein cholesterol (non-HDL-C), which is calculated as total cholesterol minus HDL-C (and represents the cholesterol content of all atherogenic apolipoprotein B-containing lipoproteins), has emerged as a better risk predictor for CVD than LDL-C and an alternative target for CVD risk reduction. Major international guidelines recommend evaluating non-HDL-C as part of atherosclerotic CVD risk assessment, especially in people with high triglycerides, diabetes, obesity, or very low LDL-C. A non-HDL-C target of <130 mg/dL (3.4 mmol/L) has been recommended for patients at very high risk, which is 30 mg/dL (0.8 mmol/L) higher than the corresponding LDL-C target goal. Non-HDL-C lowering approaches include reducing LDL-C and triglyceride levels, increasing HDL-C, or targeting multiple risk factors simultaneously. However, despite the growing evidence for the role of non-HDL-C in residual CVD risk, and recommendations for its assessment in major guidelines, non-HDL-C testing is not routinely done in clinical practice. Thus, there is a need for increased awareness of the need for non-HDL-C testing for ascertaining CVD risk and concomitant prevention of CVD.

摘要

相似文献

[1]
Residual Atherosclerotic Cardiovascular Disease Risk: Focus on Non-High-Density Lipoprotein Cholesterol.

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[2]
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[3]
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引用本文的文献

[1]
Non-traditional lipid biomarkers in atherosclerotic cardiovascular disease: pathophysiological mechanisms and strategies to address residual risk.

Front Endocrinol (Lausanne). 2025-7-10

[2]
Lipoprotein cholesterol ratios and cardiovascular disease risk in US adults: a cross-sectional study.

Front Nutr. 2025-4-17

[3]
Association of atherogenic index of plasma trajectory with the incidence of cardiovascular disease over a 12-year follow-up: findings from the ELSA cohort study.

Cardiovasc Diabetol. 2025-3-19

[4]
Association between lipoprotein(a) and coronary heart disease risk in type 2 diabetes mellitus and evaluation of statin treatment effects.

Rev Assoc Med Bras (1992). 2025-3-17

[5]
Triglycerides and Residual Risk of CVD.

J Atheroscler Thromb. 2025-7-1

[6]
Bone marrow mesenchymal stem cell-derived extracellular vesicles alleviate diabetes-exacerbated atherosclerosis via AMPK/mTOR pathway-mediated autophagy-related macrophage polarization.

Cardiovasc Diabetol. 2025-1-29

[7]
Association between sensitivity to thyroid hormones and non-high-density lipoprotein cholesterol levels in patients with type 2 diabetes mellitus.

World J Diabetes. 2024-10-15

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