Do Triglyceride-Rich Lipoproteins Equal Low-Density Lipoproteins in Risk of ASCVD?

Publikation: Bidrag til tidsskriftReviewForskningfagfællebedømt

Purpose of Review: Recent large clinical trials have failed to show that triglyceride-rich lipoprotein-lowering therapies decrease the risk of atherosclerotic cardiovascular disease (ASCVD). In this review, we reconcile these findings with evidence showing that elevated levels of triglyceride-rich lipoproteins and the cholesterol they contain, remnant cholesterol, cause ASCVD alongside low-density lipoprotein (LDL) cholesterol. Recent Findings: Results from observational epidemiology, genetic epidemiology, and randomized controlled trials indicate that lowering of remnant cholesterol and LDL cholesterol decrease ASCVD risk by a similar magnitude per 1 mmol/L (39 mg/dL) lower non-high-density lipoprotein cholesterol (remnant cholesterol+LDL cholesterol). Indeed, recent guidelines for ASCVD prevention recommend the use of non-high-density lipoprotein cholesterol instead of LDL cholesterol. Summary: Current consensus is moving towards recognizing remnant cholesterol and LDL cholesterols as equals per 1 mmol/L (39 mg/dL) higher levels in the risk assessment of ASCVD; hence, triglyceride-rich lipoprotein-lowering therapies should also lower levels of non-HDL cholesterol to reduce ASCVD risk.

TidsskriftCurrent Atherosclerosis Reports
Sider (fra-til)795-803
Antal sider9
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
Independent Research Fund Denmark (grant 1030-00168B), Novo Nordisk Foundation (grant NNF21OC0071977), Johan and Lise Boserup Fund, Aase and Ejnar Danielsen Fund, and Herlev and Gentofte Hospital provided funding. The funders had no role in the design of the study or in the collection, analysis, interpretation of data, writing the manuscript, or the decision to submit the article for publication.

Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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