LDL Pattern B

My VAP test results in July 07 identified an LDL Pattern B.
Overall results:
Total 150
HDL 75
LDL 61
Trig 60
HDL2 17
LP(a) 6.0
LDL Pattern B

Medications:
Lipitor 10mg
Zetia 10mg
Altace 10mg
Atenolol 50mg
Plavix 75mg
Aspirin 81mg

I had several heart attacks which resulted in CABG performed May 2000. I am a 53 year old white male , 6'1", 190 pounds, exercise every day, watch my diet and feel great. Everything looks OK except my LDL Pattern B. Is there any therapy to improve the Patten B?

[CCF-M.D.-CA]

Your results indicate an LDL pattern B, which generally indicates small atherogenic LDL particles which may cause increased risk for CAD. However, there are several problems with LDL patterning: 1) its  unreliability (of LDL pattern testing ), 2) unclear clinical evidence regarding regarding the usefulness of LDL patterns and particle size. The majority of evidence regarding the progression of atherosclerosis is with LDL lowering and to an smaller extent HDL raising.
All available clinical evidence shows that any particles in the VLDL, IDL, or LDL range are atherogenic, and there is no evidence that whether belonging to pattern A or B one is more atherogenic than others.
Subclass studies have proliferated over the last few years, but many of these studies were funded or subsidized either by suppliers of the assays as a method to expand their use and move them into mainstream practice, or by pharmaceutical companies in an attempt to claim some advantage over other therapeutic agents.
Thus, current data on LDL subclasses are at best incomplete and at worst misleading, suffering from publication bias, and now given the recent results of the Ensign et al. study, unreliable.
Your LDL, and HDL are at goal. The Lpa level is still not clearly linked as a modifiable risk factor for CAD, although elevated levels are now know to be linked to stroke.
Continue with your present treatments: aspirin, plavix, ateonol and altace are all essential medications.

[rags2riches]

I am a 67 year old female. small frame and thin and I play tennis at least twice a week.  On a recent check up I was found to have high cholesterol 260, High LDL P (1123)  High HDL P My Homocystine Level was also High at 16.2.  Triglycerides normal and all other LDL and HDL normal.  My B/P was 110/70.  My physician also noted a bruit in my Carotid Arteries and Abdomen.  Us showed stenois of the Carotids with no interuption in blood flow and the Aorta was 1.2, 1.3, 1.5 and showed Sclerosis.  Now what.  do I have cardiac disease and what can I do to reverse this.  I have always been in good health and my Cardiac Risk Profile was always normal before this.  Thank you.

[Colin555]

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