Oxidized Phospholipids, Lp(a) Lipoprotein, and Coronary Artery Disease
A quick review of biochemistry before we go on. LDL is generally considered the “bad” cholesterol but this view is archaic. The large, less dense LDL particles (called Type A) are much less damaging. It is believed that the lipids on this particle are easily removed in the liver, leaving mainly protein. On the other side of the coin is the small, dense LDL particles (called Pattern B). The main protein component of this small, dense LDL is apo B100. These show high correlations w/ CVD risk. Lipoprotein a or lp(a), is a known risk factor for cardiovascular disease.
So, the researchers looked at the contribution of oxidized LDL (remember-cholesterol does not do damage to us until it gets damaged and becomes oxidized) and lp(a) together on the risk of CAD. The highest levels of either oxidized LDL or lp(a) in a patient with high cholesterol produced a staggering odds ratio of 16.8 and 14.2 respectively. That means your risk is 16 TIMES AS HIGH. And, given that CVD is a top killer, this translates into some serious risk. The problem? Most clinicians probably are unaware of how to spell lp(a), let alone use it to assess risk.