Study finds lipid ratios superior to LDL for CV risk assessment

LOW-density lipoprotein (LDL) cholesterol may not be the best lipid measure of cardiovascular (CV) risk and may be replaced by more appropriate lipid ratios in future guidelines, an expert says.

A Swedish study of CV event prediction in 18,000 patients with type 2 diabetes showed that a ratio of non-high-density lipoprotein (non-HDL) to high-density lipoprotein (HDL) was superior to LDL levels.

The researchers showed that non-HDL:HDL conferred a 38% increased CV risk for every increment over baseline, compared with only a 33% increased risk for every increment of LDL over baseline.

For an LDL target below 2.5 mmol/L, the risk of CV events was reduced by 38% for non-HDL:HDL, compared with only a 30% reduction for LDL.

“A reason for the weaker association between LDL cholesterol and CHD [coronary heart disease] may be that LDL cholesterol values do not entirely reflect the role of small dense atherogenic LDL cholesterol particles,