Total Cholesterol/HDL Cholesterol Ratio vs LDL Cholesterol/HDL Cholesterol Ratio as Indices of Ischemic Heart Disease Risk in Men

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Abstract
DESPITE considerable advances during the past 40 years, there is increasing awareness among scientists, epidemiologists, and clinicians that current approaches to evaluation of coronary heart disease (CHD) risk in asymptomatic individuals remain suboptimal.1 There is also controversy around recommending widespread use of additional metabolic markers, such as apolipoprotein (APO) levels, indices of fibrinolytic activity and of susceptibility to thrombosis (eg, plasminogen activator inhibitor–1 and lipoprotein[a] levels), markers of inflammation (eg, C-reactive protein levels), and markers of insulin resistance (waist circumference and fasting insulin levels).2-9 Although all of these markers have been shown to predict CHD events, whether these variables contribute to CHD risk independently of the variation in traditional risk factors and lipid variables remains a matter of debate.