Non-high-density lipoprotein cholesterol in secondary prevention of coronary artery disease: a unique risk factor or redundant information?
OBJECTIVE
The purpose of this study was to assess the changes in standard lipid measures such as total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in comparison with changes in non-HDL-C.


METHODS
Data from 100 participants in a phase II cardiac rehabilitation program at entry and 12 weeks were assessed for changes in lipid measures. Eighty-six percent of participants were on stable lipid therapy throughout the 12-week period. Participants were classified as meeting or not meeting optimal levels of LDL-C, HDL-C, and non-HDL-C. Differences in classification for each measure were compared using the Fisher exact tests.


RESULTS
Changes in total cholesterol and LDL-C were not significant (P = .24 and P = .23, respectively). There was a significant increase in HDL-C (2.22 +/- 0.97 mg/dL, P = .0243). Non-HDL-C and triglycerides tended to decrease but did not reach significance (P = .08 and P = .96, respectively). At baseline, non-HDL-C classified a significantly higher number of participants as none optimal than did LDL-C (P < .0001). At the 12-week follow-up, a significantly higher number of participants were classified as optimal by non-HDL-C measures than by LDL-C (P < .0001).


CONCLUSIONS
Non-HDL-C provides additional information to that of standard lipid measures in secondary prevention. Non-HDL-C independently classifies risk levels of participants and is responsive to traditional rehabilitation.
Holcombe
Sylvia Michelle
SM
Department of Health & Exercise Science and Healthy Exercise & Lifestyle Programs, Wake Forest University, Winston-Salem, NC 27109, USA.
Brubaker
Peter H
PH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology* / Q000517:prevention & control; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention
D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D002784:Cholesterol