The Best Lipid Predictor

Presented: IA Rome, 2006; NLA Seattle 2008

Introduction

Dyslipidemia is an important cause of atherothrombotic disease (ATDd, or
atherosclerotic disease with emphasis on the thrombosis that so often precipitates the acute clinical event, such as acute myocardial infarction, acute cerebral infarction, abdominal aortic aneurysm, etc.) (1-6) Four lipid fractions are widely available for screening: total serum cholesterol (CT), low-density lipoprotein (LDL) cholesterol, a ratio between CT and high-density lipoprotein (HDL) cholesterol (hereafter termed the Framingham Fraction, or FF), and a ratio between LDL-cholesterol and HDL-cholesterol.

A newer lipid ratio between LDL-cholesterol and HDL-cholesterol, specifically the cholesterol retention fraction (CRF, or [LDL-HDL]/LDL) has been advocated (7). The CRF has been shown to be of value in predicting the population at risk of ATD (7) and in guiding therapy to maximally stabilize/regress coronary plaque angiographically (8). The purpose of this article is to compare the ability of these five lipid fractors to predict the population at risk of ATD.

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