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Curr Trend Cardiol. 2017 | Volume 1 Issue 3

September 18-19, 2017 | Toronto, Canada

Annual Conference on

HEART DISEASES

Introduction:

Non-high-density lipoprotein (non-HDL)

cholesterol is the sum of low-density lipoprotein (LDL)

cholesterol and very-low-density lipoprotein (VLDL)

cholesterol, and is usually approximated by the total

cholesterol minus HDL-cholesterol. The National Lipid

Association (NLA) has advocated the use of non-HDL

cholesterol as its favored lipid predictor. Cut-off points are

based on LDL cholesterol values, with a lower end at 100

mg/dL (2.50 mmol/L) and a higher end at 190 mg/dL (4.75

mmol/L), adding 30 mg/dL (0.75 mmol/L) to keep triglyceride

(TG) levels <150 mg/dL (1.70 mmol/L).

Objectives:

The author will demonstrate that the use of non-

HDL cholesterol has not been fully considered.

Methods:

The author will examine a general population

lipid database to demonstrate the frequency of distribution

of non-HDL cholesterol in the part of the population that

was known to have developed a form of atherothrombotic

disease (ATD) and in the part that was not known to have

done so. The effect of stratifying each non-HDL cholesterol

quintile in terms of another lipid predictor that does not

involve VLDL-cholesterol or TG will be demonstrated. The

other risk predictor is the cholesterol retention fraction

(CRF) defined as (LDL-HDL)/LDL.

Findings:

All non-HDL cholesterol quintiles above the lowest

quintile had higher frequencies in the ATD population than

in the non-ATD population. The highest two quintiles had

frequencies in the ATD population that are 2.5-times as

high as those in the non-ATD population, whereas in the

middle two quintiles, the frequency in the ATD population

was minimally higher than in the non-ATD population. In the

lowest quintile, the frequency is much higher in the non-

ATD population than in the ATD population. At any nonHDL

cholesterol quintile, the average age of ATD onset depends

on cigarette smoking (not discussed here) and the CRF. Higher

CRF levels equate to an earlier average age of ATD onset and

lower levels of CRF equate to a later onset. A 75-year-oldmale

who was a hypertensive diabetic and a former smoker was

not on statins because of low lipid levels, had clean arteries

on angiography, whereas a 45-year-old normotensive, non-

smoking patient with severe dyslipidemia (obtained at first

encounter) had a massive stroke due to carotid stenosis.

Both had non-HDL cholesterol levels in the intermediate ATD

risk quintiles.

Conclusions:

Non-HDL cholesterol is not the optimal

predictor of the population at risk of atherothrombotic

disease and its use should be reconsidered.

Speaker Biography

William E Feeman is a Physician on staff at Wood County Hospital, and in private

practice, both in Bowling Green, Ohio. He has attended Undergraduate school at Ohio

State University (1961-1966) and became interested in a career in Medicine during that

time; prior to his decision to enter Medicine, he planned to have a career in Astronomy.

He has earned his Bachelor of Science in Physiology (1961-1966). Over the last 26 plus

years, he has spent his professional life in medicine perfecting a tool to predict the

population at risk of atherothrombotic disease e and to guide therapy to maximally

stabilize/reverse that disease if extant. He has six major articles published in various

science/medical journal. He has numerous letters to the editor published in various

medical journals. All publications relate to the primary and second prevention of

atherothrombotic disease. He has presented data at many annual scientific assemblies

of the American Academy of Family Physicians and at several national and international

symposia in atherothrombotic disease. He is the founder of the Association for the

Prevention of Atherothrombotic Disease in Northwest Ohio to facilitate the spread of

knowledge about this disease.

e:

bgs43402@yahoo.com

Concerns about the use of non-HDL cholesterol as a lipid predictor

William E. Feeman

Bowling Green Study, USA