[How to manage lipid profiles and their interpretation in patients with coronary heart disease?].
Plasma lipids should - and can reliably - be measured within 24 hours of the onset of symptoms of acute coronary syndrome. They should again be measured from 1 to 3 months after the event. The level of low-density lipoproteins(LDL) cholesterol remains the marker for treatment initiation and for evaluation of therapeutic goals. The total number of atherogenic particles is a better determinant of cardiovascular risk than the LDL-cholesterol level, as are the levels of non-high-density lipoprotein (HDL)-cholesterol and apolipoprotein B. The use of apolipoprotein B by primary care physicians is limited by the lack of standardization and must be restricted to specific clinical cases. Non-HDL-cholesterol can be recommended as a secondary target in patients with high triglyceride levels. In coronary patients treated with a statin, management of abnormal levels of triglycerides and HDL-cholesterol is important to minimize the risk of recurrence.
Endocrinologie maladies métaboliques, Point Médical, F-21000, Dijon, France. michelfarnier@nerim.net
Michel
M
Farnier
D000208:Acute Disease; D000359:Aftercare; D001055:Apolipoproteins B / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D003327:Coronary Disease / Q000209:etiology / Q000517:prevention & control*; D016903:Drug Monitoring / Q000379:methods*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006949:Hyperlipidemias / Q000097:blood* / Q000150:complications / Q000517:prevention & control*; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011320:Primary Health Care; D012008:Recurrence; D040242:Risk Reduction Behavior; D055502:Secondary Prevention; D013997:Time Factors; D014280:Triglycerides / Q000097:blood
D001055:Apolipoproteins B; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D014280:Triglycerides