Accurate lipid and lipoprotein measurements, control of pre-analytical factors and consideration of biological variability are required for the reliable assessment of coronary heart disease (CHD) risk and the management of dyslipidaemia. Inclusion of high density lipoprotein-cholesterol, in addition to total cholesterol, in risk calculations is preferred to attain good sensitivity and specificity. Although the strong and independent association of triglyceride with CHD has been confirmed, its large biological variation limits its utility as a risk factor or primary treatment target. A fasting profile including triglyceride is essential however for consideration of genetic and secondary causes of dyslipidaemia and decisions on therapeutic intervention.
Kannel WB, Wilson PWF.Efficacy of lipid profiles in prediction of coronary disease. Am Heart J1992;124:768-74.
2.
Gotto AMHigh-density lipoprotein cholesterol and triglycerides as therapeutic targets for preventing and treating coronary artery disease. Am Heart J2002;144:S33-S42.
3.
Castelli WPThe triglyceride issue: a view from Framingham. Am Heart J1986;112:432-7.
4.
Manninen V., Tenkanen L., Koskinen P. et al. Joint effects of serum triglyceride and LDL cholesterol and HDL cholesterol concentrations on coronary heart disease risk in the Helsinki Heart Study. Circulation1992;85:37-45.
5.
Assmann G., Schulte H.Relation of high-density lipoprotein cholesterol and triglycerides to incidence of atherosclerotic coronary artery disease (the PROCAM experience) . Am J Cardiol1992;70:733-7.
6.
Durrington PNTriglycerides are more important in atherosclerosis than epidemiology has suggested. Atherosclerosis1998;141:S57-S62.
7.
Abbot RD, Carroll RJInterpreting multiple logistic regression coefficients in prospective observation studies. Am J Epidemiol1984;119:830-60.
8.
Phillips AN, Davey Smith G.How independent and `independent effects'? Relative risk estimation when correlated exposures are measured imprecisely. J Clin Epidemiol1991;44:86-91.
9.
Packard C., Caslake M., Shepherd J.The role of small, dense, low density lipoprotein (LDL): A new look . Int J Cardiol2000;74:517-22.
10.
Sniderman AD , Cianflone K.Measurement of apoproteins: time to improve the diagnosis and treatment of the atherogenic dyslipoproteinemias . Clin Chem1996;42:489-91.
11.
Griffin BA, Freeman DJ, Tait G. et al. Role of plasma triglyceride in the regulation of plasma low density lipoprotein (LDL) subfractions. Relative contribution of small dense LDL to coronary heart disease risk. Atherosclerosis1994;106:241-9.
12.
Stampfer MJ , Sacks FM, Salvini S., Willett WC, Hennekens CHThe Physicians Health Study. N Engl J Med1991;325:373-81.
13.
Grover SA, Coupal L., Xiao-Ping H.Identifying adults at increased risk of coronary disease. How well do the current cholesterol guidelines work?JAMA1995;274:801-06.
14.
The International Task Force for Prevention of Coronary Heart Disease /International Atherosclerosis Society.Coronary heart disease: reducing the risk. Nutr Metab Cardiovasc Dis1998;8:205-71.
15.
Executive Summary of the Third Report of the National Cholesterol EducationProgram (NCEP) Expert Panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA2001;285:2486-97.
16.
Wood D., De Backer G., Faegman O. et al., together with members of the Task Force. Prevention of coronary heart disease in clinical practice: recommendations of the Second Joint Task Force of European and other Societies on Coronary Prevention. Atherosclerosis1998;140:199-270.
17.
British Cardiac Society, British Hyperlipidaemia Association, British Hypertension Society, endorsed by the British Diabetic Association.Joint British recommendations on detection, evaluation and treatment of high blood cholesterol in adults. Heart1998;80(suppl 2):S1-S29.
18.
Jackson R.Updated New Zealand Cardiovascular disease risk-benefit prediction guide. BMJ200;320:709-10.
19.
Wilson S., Johnston A., Poulter NR et al. Predicting coronary risk in the general population - is it necessary to measure high-density lipoprotein cholesterol?J Cardiovasc Risk2003;10:137-41.
20.
Durrington PN, Prais H., Bhatnagar D. et al. Indications for cholesterol-lowering medication: comparison of risk-assessment methods. Lancet1999; 353:278-81.
21.
Game FL, Jones AFCoronary heart disease risk assessment in diabetes mellitus - a comparison of PROCAM and Framingham risk assessment functions. Diabet Med2000;8:355-9.
22.
Jones AF, Walker J., Game FL et al. Comparative accuracy of cardiovascular risk prediction methods in primary care patients. Heart2001;85:37-43.
23.
Durrington PN, Prais H.Methods for the prediction of coronary heart disease. Heart2001;85:489-90.
24.
Durrington PNRigorous detection and vigorous treatment of familial hypercholesterolaemia. Lancet2001;357:574-5.
25.
National Service Framework for coronary heart disease. London: Department of Health, 2000 (www.doh.gov.uk/nsf/coronary.htm#chdnsf).
26.
McNamarra JR , Teng Leary E., Ceriotti F. et al. Point Status of lipid and lipoprotein standardisation. Clin Chem1997;43:1306-14.
27.
Myers GL, Kimberly MM, Waymack PP et al. A reference method laboratory network for cholesterol: a model for standardisation and improvement of clinical laboratory measurements. Clin Chem200;46:1762-72.
28.
Ricos C., Alvarez F., Cava JV et al. Current databases on biological variation: pros, cons and progress . Scand J Clin Lab Invest1999;59:491-500.
29.
Fraser CG, Harris EKGeneration and application of data on biological variation in clinical chemistry . Crit Rev Clin Lab Sci1989;27:409-37.
30.
Jessen HJ, Dass CJ, Eckfeldt JHDo enzymatic analyses of serum triglycerides really need blanking for free glycerol. Clin Chem1990;3:1372-5.
31.
Nauck M., Warnick R., Rifai N.Methods for measurement of LDL cholesterol: A critical assessment of direct measurement by homogeneous assays versus calculation. Clin Chem2002;48:236-54.
32.
Scharnagi H. , Nauck M., Wieland H., Marz W.The Friedewald formula underestimates LDL cholesterol at low concentrations. Clin Chem Lab Med2001;39:426-31.
33.
Miremadi S. , Sniderman A., Frohlich J.Can measurement of serum apolipoprotein B replace the lipid profile monitoring of patients with lipoprotein disorders?Clin Chem2002;48:484-8.
