MUNICH, Germany – A simple test that scrutinizes bad cholesterol more closely may more reliably predict who is going to have a heart attack, new research indicates.
The current test measures total cholesterol and the breakdown of good HDL and bad LDL cholesterol. The new test, discussed Tuesday at the annual meeting of the European Society of Cardiology, instead measures the ratio of bad LDL cholesterol particles to good HDL cholesterol particles.
The smaller bad particles are called apolipoprotein B molecules and the good ones are called apolipoprotein A1 molecules. A ratio of 1 to 2 is considered low risk, while a ratio approaching 1 to 1 would be considered high risk, and anything over that – where the small LDL particles would dominate – would be very high risk.
If the LDL is mostly made up of small particles, that’s bad because they are dense and are the building blocks of plaque. The big ones are more easily carried away by the blood flow.
The test was used in a major study investigating what causes heart attacks because researchers suspected it might be a better predictor of heart trouble than standard cholesterol tests.
The study found the standard cholesterol test did not correlate well with heart attacks, but that the new method was a better indicator. A high ratio of small LDL molecules to good cholesterol turned out to be the most important factor linked to heart attack risk, even before smoking.
Patients with the worst test results were about four times more likely than those with the best score to have a heart attack.
One of the main practical advantages of the new test is that blood can be drawn at any time. The current cholesterol test can only be done after the patient fasts for 12 hours. A machine then reads the cholesterol molecules and gives a ratio count.
Talk to us
> Give us your news tips.
> Send us a letter to the editor.
> More Herald contact information.
