Other Surrogate Markers than TC or LDL-C

Triglycerides to HDL Ratio

“Elevation in the ratio of TG to HDL-c was the single most powerful predictor of extensive coronary heart disease among all the lipid variables examined.”

– High Ratio of Triglycerides to HDL-Cholesterol Predicts Extensive Coronary Disease, Protasio Lemos da Luz, et. al., Clinics, 2008 Aug; 63(4): 427–432.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664115/

High HDL

“In a large cohort of patients hospitalized with CAD [136,905], . . . [m]ore than half the patients have admission HDL levels <40 mg/dL, whereas <10% have HDL ≥60 mg/dL.”

– Lipid levels in patients hospitalized with coronary artery disease: An analysis of 136,905 hospitalizationsAmit Sachdeva MD, et. al., Get With The Guidelines, American Heart Journal, Volume 57, Issue 1, January 2009.

https://www.sciencedirect.com/science/article/pii/S0002870308007175

IR: Insulin Resistance

“Emerging evidence shows that insulin resistance is the most important predictor of cardiovascular disease and type 2 diabetes.”

– The cholesterol and calorie hypotheses are both dead — it is time to focus on the real culprit: insulin resistance, Maryanne Demasi, et. al, Clinical Pharmacist, 14 Jul 2017.

http://tinyurl.com/yy6hsg49

CAC (Coronary Artery Calcification) Score

“A zero CAC score in patients undergoing CT scanning for suspected stable angina has a high negative predictive value for the exclusion of obstructive CAD and is associated with a good medium-term prognosis.”

– A zero coronary artery calcium score in patients with stable chest pain is associated with a good prognosis, despite risk of non-calcified plaques, Xue Wang, et. al., BMJ Open Heart, Vol. 6, issue 1.

https://openheart.bmj.com/content/6/1/e000945


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