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Non-high density lipoprotein cholesterol versus low density lipoprotein cholesterol as a discriminating factor for myocardial infarction.

Abstract

BACKGROUND

Serum total cholesterol (TC) and LDL cholesterol (LDL-C) have been used as major laboratory measures in clinical practice to assess cardiovascular risk in the general population and disease management as well as prognosis in patients. However, some studies have also reported the use of non-HDL cholesterol (non-HDL-C). As non-HDL-C can be calculated by subtracting HDL-C from TC, both of which do not require fasting blood sample in contrast to LDL-C which requires fasting blood sample, we aimed to compare non-HDL-C with LDL-C as a predictor of myocardial infarction (MI).

METHODS

This hospital based cross sectional study was undertaken among 51 cases of MI and equal number of controls. MI was diagnosed based on the clinical history, ECG changes and biochemical parameters. 5 mL of fasting blood sample was collected from each research participant for the analysis of lipid profile. Non-HDL-C was calculated by using the equation; Non-HDL-C = TC - HDL-C. Statistical analysis was performed using SPSS 14.0.

RESULTS

42 MI cases were dyslipidemic in contrast to 20 dyslipidemic subjects under control group. The differences in the median values of each lipid parameter were statistically significant between MI cases and controls. The lipid risk factors most strongly associated with MI were HDL-C (OR 5.85, 95% CI 2.41-14.23, P value = 0.000) followed by non-HDL-C (OR 3.77, 95% CI 1.64-8.66, P value = 0.002), LDL-C/HDL-C (OR 3.38, 95% CI 1.44-7.89, P value = 0.005), TC/HDL-C (OR 2.93, 95% CI 1.36-7.56, P value = 0.026), LDL-C (OR 2.70, 95% CI 1.20-6.10, P value = 0.017), TC (OR 2.68, 95% CI 1.04-6.97, P value = 0.042) and Tg (OR 2.54, 95% CI 1.01-6.39, P value = 0.047). Area under the receiver operating curve was greater for non-HDL-C than for LDL-C. Non-HDL-C was also found to be more sensitive and specific than LDL-C for MI.

CONCLUSIONS

HDL-C and non-HDL-C are better discriminating parameters than LDL-C for MI. Thus, we can simply perform test for HDL-C and non-HDL-C both of which do not require fasting blood sample rather than waiting for fasting blood sample to measure LDL-C.

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  • Authors+Show Affiliations

    ,

    Department of Biochemistry, Manipal College of Medical Sciences, Pokhara, Nepal. manoj.sigdel@hotmail.com

    , , , , ,

    Source

    BMC research notes 5: 2012 Nov 17 pg 640

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Case-Control Studies
    Cholesterol
    Cholesterol, HDL
    Cholesterol, LDL
    Cross-Sectional Studies
    Fasting
    Female
    Humans
    Male
    Middle Aged
    Myocardial Infarction
    ROC Curve
    Reference Values
    Risk Factors
    Triglycerides

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    23158803

    Citation

    Sigdel, Manoj, et al. "Non-high Density Lipoprotein Cholesterol Versus Low Density Lipoprotein Cholesterol as a Discriminating Factor for Myocardial Infarction." BMC Research Notes, vol. 5, 2012, p. 640.
    Sigdel M, Yadav BK, Gyawali P, et al. Non-high density lipoprotein cholesterol versus low density lipoprotein cholesterol as a discriminating factor for myocardial infarction. BMC Res Notes. 2012;5:640.
    Sigdel, M., Yadav, B. K., Gyawali, P., Regmi, P., Baral, S., Regmi, S. R., & Jha, B. (2012). Non-high density lipoprotein cholesterol versus low density lipoprotein cholesterol as a discriminating factor for myocardial infarction. BMC Research Notes, 5, p. 640. doi:10.1186/1756-0500-5-640.
    Sigdel M, et al. Non-high Density Lipoprotein Cholesterol Versus Low Density Lipoprotein Cholesterol as a Discriminating Factor for Myocardial Infarction. BMC Res Notes. 2012 Nov 17;5:640. PubMed PMID: 23158803.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Non-high density lipoprotein cholesterol versus low density lipoprotein cholesterol as a discriminating factor for myocardial infarction. AU - Sigdel,Manoj, AU - Yadav,Binod Kumar, AU - Gyawali,Prajwal, AU - Regmi,Prashant, AU - Baral,Sushil, AU - Regmi,Shyam Raj, AU - Jha,Bharat, Y1 - 2012/11/17/ PY - 2012/09/03/received PY - 2012/11/13/accepted PY - 2012/11/20/entrez PY - 2012/11/20/pubmed PY - 2013/5/25/medline SP - 640 EP - 640 JF - BMC research notes JO - BMC Res Notes VL - 5 N2 - BACKGROUND: Serum total cholesterol (TC) and LDL cholesterol (LDL-C) have been used as major laboratory measures in clinical practice to assess cardiovascular risk in the general population and disease management as well as prognosis in patients. However, some studies have also reported the use of non-HDL cholesterol (non-HDL-C). As non-HDL-C can be calculated by subtracting HDL-C from TC, both of which do not require fasting blood sample in contrast to LDL-C which requires fasting blood sample, we aimed to compare non-HDL-C with LDL-C as a predictor of myocardial infarction (MI). METHODS: This hospital based cross sectional study was undertaken among 51 cases of MI and equal number of controls. MI was diagnosed based on the clinical history, ECG changes and biochemical parameters. 5 mL of fasting blood sample was collected from each research participant for the analysis of lipid profile. Non-HDL-C was calculated by using the equation; Non-HDL-C = TC - HDL-C. Statistical analysis was performed using SPSS 14.0. RESULTS: 42 MI cases were dyslipidemic in contrast to 20 dyslipidemic subjects under control group. The differences in the median values of each lipid parameter were statistically significant between MI cases and controls. The lipid risk factors most strongly associated with MI were HDL-C (OR 5.85, 95% CI 2.41-14.23, P value = 0.000) followed by non-HDL-C (OR 3.77, 95% CI 1.64-8.66, P value = 0.002), LDL-C/HDL-C (OR 3.38, 95% CI 1.44-7.89, P value = 0.005), TC/HDL-C (OR 2.93, 95% CI 1.36-7.56, P value = 0.026), LDL-C (OR 2.70, 95% CI 1.20-6.10, P value = 0.017), TC (OR 2.68, 95% CI 1.04-6.97, P value = 0.042) and Tg (OR 2.54, 95% CI 1.01-6.39, P value = 0.047). Area under the receiver operating curve was greater for non-HDL-C than for LDL-C. Non-HDL-C was also found to be more sensitive and specific than LDL-C for MI. CONCLUSIONS: HDL-C and non-HDL-C are better discriminating parameters than LDL-C for MI. Thus, we can simply perform test for HDL-C and non-HDL-C both of which do not require fasting blood sample rather than waiting for fasting blood sample to measure LDL-C. SN - 1756-0500 UR - https://www.unboundmedicine.com/medline/citation/23158803/Non_high_density_lipoprotein_cholesterol_versus_low_density_lipoprotein_cholesterol_as_a_discriminating_factor_for_myocardial_infarction_ L2 - https://bmcresnotes.biomedcentral.com/articles/10.1186/1756-0500-5-640 DB - PRIME DP - Unbound Medicine ER -