Physicians' Academy for Cardiovascular Education

Non-HDL-C a better predictor of mortality than LDL-C

Usefulness of Non-High Density Lipoprotein Cholesterol as a Predictor of Cardiovascular Disease Mortality in Men in 22 Year Follow Up

Literature - Harari G, Green MS, Magid A, et al. - Am J Cardiol 2017; published online ahead of print


Conflicting data exist regarding the superiority of non-HDL-C for the prediction of cardiovascular disease (CVD) risk, compared with LDL-C [1-5]. Therefore, there is a need to assess the predictive value of non-HDL-C for CVD and total mortality, in comparison to the predictive value of LDL-C in various populations.

In the prospective Cardiovascular Occupational Risk Factor Determination in Israel Study (CORDIS), it was evaluated whether lipid levels, including non-HDL-C, in 4,832 young, apparently healthy, male workers from 21 industrial plants have a better predictive value for total mortality and CVD mortality, compared with other lipid measures, in a long-term follow-up of 22 years, ending in 2007. The current analysis was restricted to a working population of Jewish men aged 20 to 70 years at baseline. Arab men were excluded from the current analysis.

Main results


In a large population of young males who were followed-up for 22 years, non-HDL-C was a more potent predictor of CVD mortality compared with LDL-C levels, after adjustment for many relevant confounding factors. These findings support existing data, according to which, non-HDL-C should be preferred over LDL-C for CV risk stratification. Interestingly, higher levels of non-HDL-C seemed to attenuate the “protective” effect of lower levels of LDL-C, although these results need to be confirmed in larger studies.


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