Limitations of LDL-cholesterol for CVD risk stratification
LDL-C (Low-density lipoprotein cholesterol) is one of the main parameters of national guidelines for the prevention of coronary heart disease. Nevertheless LDL-C levels are insufficient to identify individuals at high risk, since many "events" occur in individuals without elevated LDL-C.
Limitations of total cholesterol for CVD risk stratification
Cardiovascular events are not necessarily associated with high total cholesterol levels. In fact, 35% of CHD occur in people with total cholesterol levels below 200 mg/dL.
The predictive value of traditional atherosclerotic risk markers is limited. Lp-PLA2 is able to overcome these limitations and, therefore, represents a powerful tool to close the diagnostic gap.
Limitations of currently used CVD risk assessment
Several studies have demonstrated that high total cholesterol and high LDL-cholesterol are major modifiable risk factors for cardio artery disease (CAD). Many risk estimation tools are available. Most of them are based on conventional risk factors as age, sex, smoking, blood pressure, and lipid levels.
Previously it was shown in a large cohort trial with more than 135.000 patients hospitalized with coronary artery disease, that 77% of the patients showed normal or borderline LDL-C values with less than 130 mg/dL (3.4 mmol/L). In more than 45% of these patients high density lipoprotein cholesterol was found in the normal range (>40 mg/dL (>1.03 mmol/L)) and additionally, more than 60% of the participants exhibited triglyceride levels in the normal or borderline range (below 150 mg/dL (1.69 mmol/L)).
These findings provide further evidence that currently used risk assessment with the lipid profile shows limitations and is not sufficient to identify the entirety of high-risk patients.