Very important blood test- particle number and size

[broker]

Guys
Although we all need to get LDL cholesterol checked, the more important number is particle size and particle number.
You can have good LDL numbers but if the particle number is high and the particles are small, you are at very high risk of a cardio vascular event.
Get those numbers checked.

 

[RPellerin]

My Apolipoprotein B is high at 206, and Lp-PLA2 is high at 228, which means they are sticky.
Started Crestor last week, at 10mg/daily.
At 55 I put off getting on a statin until now.
Last year my calcium score was "0".
Hopefully it is the right decision for me.

 

[Golfboy307]

RP - what made you finally decide on a statin with a zero calcium score at 55? Your arteries look to be in great shape.

My LDL reading has been below 100 for quite awhile, but my particle count has ranged from 850 to 1200, which puts me in the "moderate risk" category. Like you I had a zero calcium score, but that was 10 years ago. Need another one.

 

[Vince]

The major lipoprotein types, very low-density lipoprotein (VLDL), low-density lipoprotein (LDL), and high-density lipoprotein (HDL), are composed of many subgroups (1–3). Classifications are based on size (1), density, or apolipoprotein (apo) content (2), or a combination of these (3), and the subfractions that are isolated have distinct metabolic and other functional properties. Thus, it is entirely reasonable to think that subfractions of the major lipoproteins have diverse relationships to coronary heart disease (CHD). Because the classical lipid risk factors by no means perfectly predict CHD in patients, lipoprotein subfractionation has the potential to improve risk prediction.

Low-Density Lipoprotein Size and Cardiovascular Disease: A Reappraisal

 

[broker]

You can have a good Ldl number but if the particle number is high, you have a bigger risk. Thats why some guys with seemingly good cholesterol levels still get heart attacks or strokes. Too many general practitioners ignore particle number. Increased particle number means smaller particles which have a much greater chance of sticking to or penetrating artery walls.
A great way to lower LDL particle number and increase particle size is to lower tryglycerides and cut down on trans fats. Rememer, ldl also carries tryglycerides.
Some of us genetically produce more LDL just as some people produce too much or too little thyroid. Statins are great drugs if used properly.
A professor at Oxford University who has very good cholesterol numbers says “ everyone over 50 should use a statin”.

 

[Blackhawk]

LOL. Keep trying...

There is NO CONCLUSIVE EVIDENCE THAT PARTICLE SIZE OR PARTICLE NUMBER IS THE CAUSATIVE SMOKING GUN. Once again these theories are all based on statistical association and hypothesis.

One Dr's opinion based on his training deep within the major medical propaganda system is not categorical proof of anything.

In an analogous sense, keep in mind all the doctors treating hypogonadism that actually have zero idea what they are actually doing and how frequently men are put on bad TRT protocols that fail. This is the same across the board in medicine.

We've been through all of this on this forum numerous times before. I personally had these advanced lipid tests and there was no smoking gun, no telltale marker indicating high risk for me. I also have never had weight problems, insulin resistance, bad diet, lack of exercise etc. My only contributors to risk were stress and possibly too much Omega 6 intake.

I had 95-98% occlusion of the LAD and a stent paced in 2014. The tests were worthless in predicting anything for me.

Like I said, keep trying. There may be some breakthrough in terms of prevention, and generally living well, eating well, being healthy overall are good things to do for the human organism. And certainly live by your own belief system, however you aquire it.

However, your wholesale shilling of statins here is frankly ridiculous. Advocating use of statins for everyone is murderous advice, and statin use should remain an individual personal decision.

 

[RPellerin]

RP - what made you finally decide on a statin with a zero calcium score at 55? Your arteries look to be in great shape.

My LDL reading has been below 100 for quite awhile, but my particle count has ranged from 850 to 1200, which puts me in the "moderate risk" category. Like you I had a zero calcium score, but that was 10 years ago. Need another one.

Why, primarily because of the density of my lipids.
I have been on an organic paleo diet for nearly a decade and am in great physical condition.
My total cholesterol is 349, was 452 last year while following keto.
My CRP is good at 0.74 (0.0-3.0)

I have been pondering this decision for many years, seems to be the prudent thing to do with my numbers. Many times I read different groups and people talk about their numbers being "high", and don't state the value. I think it's fair to say mine are high.

Other values:
Triglycerides - 107
HDL - 50

 

[Golfboy307]

Rp, thanks for the reply. Makes sense.

Blackhawk - If you had none of the risk factors of this multifaceted disease, then you are truly an outlier. But living proof that we don't know it all, especially with CAD.

My dad died at 44 of a heart attack. He smoked, ate poorly and had high BP. Pretty safe to say those three things shortened his life. Do I have a genetic predisposition to CAD (likely)? But can I affect the other risk factors? I believe so. Time will tell..

My stepdad had a major heart attack when he was 72, with three other major blockages. Four stents. They put him on beta blockers, statins, the works. He will turn 91 this May and his heart has kept on ticking.

We are complicated creatures for sure.

 

[Blackhawk]

Blackhawk - If you had none of the risk factors of this multifaceted disease, then you are truly an outlier. But living proof that we don't know it all, especially with CAD.

I am still not fully convinced that I did not have this: https://www.ahajournals.org/doi/full/10.1161/circulationaha.111.037283

My angiogram pictures were near identical in one branch of the artery, and the cardiologist who did the stent said that there was a band of contractile muscle fiber over the narrowed site.

My cardiologist was disinterested in the possibility of coronary artery spasm.

 

[xqfq]

LOL. Keep trying...

There is NO CONCLUSIVE EVIDENCE THAT PARTICLE SIZE OR PARTICLE NUMBER IS THE CAUSATIVE SMOKING GUN. Once again these theories are all based on statistical association and hypothesis.

One Dr's opinion based on his training deep within the major medical propaganda system is not categorical proof of anything.

In an analogous sense, keep in mind all the doctors treating hypogonadism that actually have zero idea what they are actually doing and how frequently men are put on bad TRT protocols that fail. This is the same across the board in medicine.

We've been through all of this on this forum numerous times before. I personally had these advanced lipid tests and there was no smoking gun, no telltale marker indicating high risk for me. I also have never had weight problems, insulin resistance, bad diet, lack of exercise etc. My only contributors to risk were stress and possibly too much Omega 6 intake.

I had 95-98% occlusion of the LAD and a stent paced in 2014. The tests were worthless in predicting anything for me.

Like I said, keep trying. There may be some breakthrough in terms of prevention, and generally living well, eating well, being healthy overall are good things to do for the human organism. And certainly live by your own belief system, however you aquire it.

However, your wholesale shilling of statins here is frankly ridiculous. Advocating use of statins for everyone is murderous advice, and statin use should remain an individual personal decision.

I'm curious about your case because I spend a lot of time studying lipids / CVD. Would you mind posting your lab results? You say you did advanced lipoprotein testing, etc.

In particular, if you have any of these:

* LDL-P / HDL-P - NMR lipid panel, if done
* Apo B, Apo A-1
* Lp(a)
* Standard lipid panel
* A1c, fasting glucose
* Inflammation markers: LP-PLA2, MPO, F2 isoprostanes

Did anything change between when you had these labs drawn and, say, 10 years ago? Major changes in smoking status, exercise, diet, weight, blood pressure? It's possible you used to have some poor values but now have better ones.

 

[Blackhawk]

Yes I would mind. Like I said it's all been covered before on this forum, including my labs over time. You can search to your heart's content.