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: 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