Non-HDL-cholesterol in dyslipidemia: Review of the state-of-the-art literature and outlook.

Autor: Raja V; Abbott Products Operations AG, Basel, Switzerland., Aguiar C; Department of Cardiology, Hospital Santa Cruz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal., Alsayed N; Dar Alsaha Medical Center, Bahrain., Chibber YS; WNS Global Services, Noida, India., ElBadawi H; Internal Medicine Department, Wayne State University, Detroit, MI, USA; Metabolic Unit, My Clinic International, Jeddah, Saudi Arabia., Ezhov M; National Medical Research Center of Cardiology n.a. ac. E.I. Chazov, Moscow, Russia., Hermans MP; Université Catholique de Louvain, Brussels, Belgium., Pandey RC; WNS Global Services, Noida, India., Ray KK; Imperial Centre for Cardiovascular Disease Prevention, Imperial College London, UK., Tokgözoglu L; Hacettepe University, Ankara, Turkey., Zambon A; University of Padua, Padua, Italy., Berrou JP; Abbott Products Operations AG, Basel, Switzerland. Electronic address: jean-pascal.berrou@abbott.com., Farnier M; PEC2, EA 7460, University of Bourgogne, Dijon, France. Electronic address: farnier.michel@orange.fr.
Jazyk: angličtina
Zdroj: Atherosclerosis [Atherosclerosis] 2023 Oct; Vol. 383, pp. 117312. Date of Electronic Publication: 2023 Sep 30.
DOI: 10.1016/j.atherosclerosis.2023.117312
Abstrakt: Dyslipidemia refers to unhealthy changes in blood lipid composition and is a risk factor for atherosclerotic cardiovascular diseases (ASCVD). Usually, low-density lipoprotein-cholesterol (LDL-C) is the primary goal for dyslipidemia management. However, non-high-density lipoprotein cholesterol (non-HDL-C) has gained attention as an alternative, reliable goal. It encompasses all plasma lipoproteins like LDL, triglyceride-rich lipoproteins (TRL), TRL-remnants, and lipoprotein a [Lp(a)] except high-density lipoproteins (HDL). In addition to LDL-C, several other constituents of non-HDL-C have been reported to be atherogenic, aiding the pathophysiology of atherosclerosis. They are acknowledged as contributors to residual ASCVD risk that exists in patients on statin therapy with controlled LDL-C levels. Therefore, non-HDL-C is now considered an independent risk factor or predictor for CVD. The popularity of non-HDL-C is attributed to its ease of estimation and non-dependency on fasting status. It is also better at predicting ASCVD risk in patients on statin therapy, and/or in those with obesity, diabetes, and metabolic disorders. In addition, large follow-up studies have reported that individuals with higher baseline non-HDL-C at a younger age (<45 years) were more prone to adverse CVD events at an older age, suggesting a predictive ability of non-HDL-C over the long term. Consequently, non-HDL-C is recommended as a secondary goal for dyslipidemia management by most international guidelines. Intriguingly, geographical patterns in recent epidemiological studies showed remarkably high non-HDL-C attributable mortality in high-risk countries. This review highlights the independent role of non-HDL-C in ASCVD pathogenesis and prognosis. In addition, the need for a country-specific approach to dyslipidemia management at the community/population level is discussed. Overall, non-HDL-C can become a co-primary or primary goal in dyslipidemia management.
(Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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