NEW ORLEANS — Measuring non-HDL cholesterol level may be a better primary screen for risk of first nonfatal myocardial infarction in women than measuring the level of LDL cholesterol, reported Wildon R. Farwell, M.D.
Recent studies have implicated non-HDL cholesterol—including triglyceride-rich very low-density-lipoprotein cholesterol and intermediate-density-lipoprotein cholesterol—as atherogenic, Dr. Farwell said at the annual meeting of the Society of General Internal Medicine.
He and his colleagues at Brigham and Women's Hospital, Boston, analyzed data on nearly 19,000 women from the Women's Health Study who neither had a diagnosis of hyperlipidemia nor took cholesterol medication. They confirmed 118 self-reported cases of first nonfatal MI and used Cox proportional hazards models to control for cardiovascular risk factors.
The mean values of LDL and non-HDL cholesterol in the 118 MI patients were 116.3 mg/dL and 147.5 mg/dL, respectively. Non-HDL cholesterol level was a more significant predictor of risk than LDL cholesterol level. The hazard ratio for the highest tertile of non-HDL cholesterol was 2.91, compared with 1.51 for LDL. Similarly, the hazard ratios for the middle non-HDL and LDL tertiles were 1.81 and 0.92, Dr. Farwell said.
The non-HDL tertile measures were defined as less than 130.1 mg/dL, from 130.1 to 159.4 mg/dL, and greater than 159.4 mg/dL. For LDL cholesterol, the tertile measures were defined as less than 102.1 mg/dL, from 102.1 to 126.6 mg/dL, and greater than 126.6 mg/dL.
“While LDL cholesterol is important, non-HDL cholesterol may be the more important predictor, at least in some groups of people,” Dr. Farwell said.