1. Non-high-density lipoprotein cholesterol versus low-density lipoprotein cholesterol in clinical practice: ANMCO position paper
- Author
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Nadia Aspromonte, Marcello Arca, Loris Roncon, Michele Massimo Gulizia, Stefano Urbinati, Manlio Cipriani, Giuseppina Maura Francese, Serafina Valente, Stefania Angela Di Fusco, Fortunato Scotto di Uccio, Vincenzo Amodeo, Andrea Di Lenarda, Massimo Leggio, Adriano Murrone, Massimo Imazio, Domenico Gabrielli, Stefano Domenicucci, Furio Colivicchi, and Pasquale Caldarola
- Subjects
Oncology ,medicine.medical_specialty ,Low density lipoprotein cholesterol ,Risk Assessment ,chemistry.chemical_compound ,Internal medicine ,Preventive Health Services ,Medicine ,Humans ,Triglycerides ,Hypolipidemic Agents ,Triglyceride ,business.industry ,Cholesterol ,Non high density lipoprotein cholesterol ,Cholesterol, HDL ,Cardiometabolic Risk Factors ,Standard of Care ,General Medicine ,Cholesterol, LDL ,Atherosclerosis ,Predictive factor ,Clinical Practice ,chemistry ,Italy ,Cardiovascular Diseases ,Biomarker (medicine) ,Position paper ,lipids (amino acids, peptides, and proteins) ,Cardiology and Cardiovascular Medicine ,business - Abstract
Bloodstream cholesterol is a central contributor to atherosclerotic cardiovascular diseases. For several decades, low-density lipoprotein cholesterol (LDL-C) has been the main biomarker for the prediction of cardiovascular events and therapeutic target of lipid-lowering treatments. More recently, several findings have supported the greater reliability of non-high-density lipoprotein cholesterol (non-HDL-C) as a predictive factor and possible therapeutic target in refining antiatherogenic treatments, especially among patients with lower LDL-C and higher triglyceride values. This article discusses the limits of current standard methods for assessing LDL-C levels and emphasizes the persistent residual cardiovascular risk in patients treated with lipid-lowering agents on the basis of recommended LDL-C targets. It highlights that patients with controlled LDL-C and non-targeted non-HDL-C have a higher cardiovascular risk. The article focuses on the role of non-HDL-C as a better predictor of atherosclerotic disease as compared with LDL-C and as a therapeutic target. Finally, this article includes an executive summary aimed at refining preventive approaches in atherosclerotic cardiovascular disease.
- Published
- 2021