Rethinking Lipid Burden and the Role of Non-LDL Biomarkers in Stroke Risk Stratification.
This article reviews the existing literature on non-LDL biomarkers in atherosclerotic cardiovascular disease (ACSVD), atherogenesis, and ischemic stroke risk, including a discussion of potential future applications for secondary prevention of stroke.
Although foundational studies established the strong link between elevated low-density lipoprotein-cholesterol (LDL-C) with the development of atherosclerosis and increased cardiovascular risk, a growing number of recent studies have shown that more precise cerebrovascular disease (CVD) risk stratification can be achieved by using other components of the traditional lipid panel along with additional lipoprotein assays. The specific relationship between these non-traditional markers of atherosclerosis and ischemic stroke risk remains incompletely defined. Lipid measures beyond LDL-C including updated interpretations of the standard lipid panel, such as the triglyceride-to-high density lipoprotein ratio (TG:HDL) as well as testing for lipoprotein (a) (Lp(a)) and apolipoprotein B (ApoB), play a important respective roles in estimating metabolic health as well as atherogenic particle burden. These measures should therefore be considered in the context of stroke risk assessment, monitoring, and secondary prevention.
Although foundational studies established the strong link between elevated low-density lipoprotein-cholesterol (LDL-C) with the development of atherosclerosis and increased cardiovascular risk, a growing number of recent studies have shown that more precise cerebrovascular disease (CVD) risk stratification can be achieved by using other components of the traditional lipid panel along with additional lipoprotein assays. The specific relationship between these non-traditional markers of atherosclerosis and ischemic stroke risk remains incompletely defined. Lipid measures beyond LDL-C including updated interpretations of the standard lipid panel, such as the triglyceride-to-high density lipoprotein ratio (TG:HDL) as well as testing for lipoprotein (a) (Lp(a)) and apolipoprotein B (ApoB), play a important respective roles in estimating metabolic health as well as atherogenic particle burden. These measures should therefore be considered in the context of stroke risk assessment, monitoring, and secondary prevention.
Authors
Kelly Kelly, Schneider Schneider, Rosso Rosso, Ishida Ishida, Rostanski Rostanski, Katz Katz
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