Non-High-Density Lipoprotein Cholesterol in Secondary Prevention of Coronary Artery Disease

In Brief PURPOSE 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. This study examined the response of non-high-density lipoprotein (non-HDL-C) cholesterol versus traditional lipids, low-density lipoprotein cholesterol, and total cholesterol in a 12-week lifestyle intervention program for secondary prevention patients. Results suggest that non-HDL-C provides unique risk factor information and should be included as an outcomes measure in cardiac rehabilitation programs.