In the following article published in the January 2009 issue of the American Heart Journal, native LDL-cholesterol and HDL-cholesterol levels were evaluated for 136,905 patients hospitalized with Coronary Artery Disease (CAD).
The mean LDL-cholesterol level among hospitalized patients with CAD was 104.9 mg/dL. Of these patients, 49.6% had LDL-cholesterol levels of <100 mg/dL, with 17.0% having LDL-cholesterol levels lower than the optimal target for high risk patients of <70 mg/dL. For the total number of patients, 77.0% had LDL Cholesterol levels of <130 mg/dL.
The mean HDL-cholesterol level among hospitalized patients with CAD was approximately 40 mg/dL.
Of these patients, 54.6% had HDL-cholesterol levels of <40 mg/dl. Only 7.8% of the patients had HDL-Cholesterol level >60 mg/dL. It is well understood that HDL-cholesterol is involved in the removal of cholesterol from the arterial wall.
This data illustrates the long standing question “why do the majority of patients with Coronary Artery Disease (CAD) have normal levels of LDL-Cholesterol?” The answer is rather simple. Oxidized LDL is the key molecule directly involved in the development and progression of atherosclerotic plaque. As described in Section D of this book, reduction of oxidized LDL resulted in “complete prevention of atherosclerotic progression despite the persistence of severe hyper-cholesterolemia and hypertriglyceridemia.”
Oxidized LDL is a more potent and more accurate marker for CAD than the time-honored, conventional blood lipid/lipoprotein biomarkers, particularly total cholesterol, LDL-cholesterol, HDL-cholesterol, and the ratio cholesterol/HDL-cholesterol.