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Risk Factors in Coronary Artery Disease

Lab Data

The laboratory test results for lipids, Lp(a), homocysteine and LDL subparticles are shown in Table 1.

Table 1: Initial laboratory findings

Analyze	Result	Reference Range	Risk for CAD
Total cholesterol	190 mg/dL N	Desirable < 200 mg/dL Borderline high 200-239 mg/dL High > 240 mg/dL	None
Total triglyceride	376 mg/dL	Normal < 200 mg/dL Borderline high 200-400 mg/dL Very high > 1000 mg/dL	High
LDL cholesterol	120 mg/dL N	Desirable < 130 mg/dL Borderline high risk 130 - 159 mg/dL High risk > 160 mg/dL	None
HDL cholesterol	28 mg/dL	Desirable > 60 mg/dL Moderate risk 35 - 39 mg/dL High risk < 35 mg/dL	High
Lipoprotein (a)	21 mg/dL N	0 - 30 mg/dL	Low
LDL subparticle size distribution	25.9 nm (60.9%) I 24.8 nm (14.6%) B	Pattern A 26.4 - 28.3 nm Intermediate pattern 25.8 - 26.3 nm Pattern B 24.3 - 25.7 nm	Moderate
Homocysteine	8.44 umol/L N	5.4 - 11.9 umol/L	Low

N indicates the result is within normal limits.
I indicates Intermediate pattern.
B indicates pattern B.
indicates a low result.
indicates a high result.

The patient's total cholesterol and low-density lipoprotein cholesterol were within normal limits and meet the recommended guidelines of the National Cholesterol Education Program (NCEP).[1] The high-density lipoprotein result was low and triglycerides were borderline high (based on NCEP recommendations for triglyceride measurements [2]). This puts him at high risk for coronary artery disease. His lipoprotein (a) concentration and homocysteine levels were within normal limits. His LDL subparticles size distribution was predominately of small dense particles. This puts the patient at an increased risk of coronary artery disease.

The patient underwent an electrocardiogram (ECG) and an exercise treadmill test (ETT). Both tests were within normal limits. He had non-significant S-T depression and no chest pain.