Ignorance based cardiology : What is the relationship between blood cholesterol and plaque cholesterol ?
Hyperlipidimia is one of the well-known coronary risk factor.Serum cholesterol ( Various fractions ) levels are measured to represent that risk. Epidemiologically ,it does a perfect job , however , the fact is , circulating lipids has little correlation with the lipids that’s deposited in the vessel wall.
Time and again , we have proven this as severity of CAD has little to do with the absolute levels of lipid levels.The number volume of plaques , the thickness of lipid core, and degree of vulnerability show poor correlation with circulating lipid levels than what we would expect.It tempts us to make a statement , that serum lipid is a poor surrogate marker for CAD. (Still, it may predict the risk of developing it !)
Why this paradox ? What are the missing links and hidden secrets ?
If you plot a simple graph with serum lipids with plaque mass, volume and content in CAD population , we might get an answer .I don’t know whether such a study exist. (Those who find one , please share)
A new concept called cholesterol crystalisation
It’s not the lipids alone that are responsible for CAD . There is a whole lot of factors , circulating pro inflammatory mediators, altered blood coagulation system , various inflammatory molecules, , heightened intra-coronary pressures, genetic vulnerabilities .
Most importantly ,the format of lipid molecule in side the plaque seems to matter more rather the absolute content.(Small dense LDL, ox...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: dr s venkatesan Tags: Cardiology -Mechnisms of disease dyslipidemia hyperlipidemia stains and ldl cholesterol crystalisation plaque lipid vs serum lipid] relationship between serum lipid and plaque cad burden relationship between serum lipids and plaque lipid con Source Type: blogs
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