Did you have Lp(a) measured ?
Before my heart attack they were only doing the standard lipid panel, which I don’t think includes apoB.
LDL was 103, 65, 78, 65, 83, 91, 87
I wouldn’t be surprised if you’re Lp(a) positive with those numbers. “Good” by conventional standards, but not sufficient over long time periods, especially with high Lp(a)
Related, where was your blockage that caused the heart attack?
High Lp(a) tends to be associated with aortic valve stenosis:
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Per the attached reference:
ApoB considerably underestimates risk in individuals with high Lp(a) levels. The association between apoB and incident CHD is diminished or even lost. These phenomena can be overcome and explained by risk-weighted apoB.
Lipoprotein(a) and risk-weighted apolipoprotein B: a novel metric for atherogenic risk – PMC
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Thanks. Clearly with an average LDL of about 80 mg/dL, 99% of doctors would say your LDL is perfect. (And they would be wrong, but that’s the state of our sickcare system…)
Are your LDL and apoB discordant now? Or are they always almost identical?
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Another issue our healthcare system may miss is the negative effect of inflammation on what the LDL or the ApoB numbers mean. If inflammation is high, as measured by hsCRP (high sensitivity C Reative Protein), then it may be that levels of OxLDL (oxidized LDL) are relatively high and may be detrimental to health.
Further, the spectrum of LDL particle sizes is also an issue. If particles are larger, they may not have an effect on the vascular wall, but if particles are small and dense they may be more easily absorbed to create soft plaque.
hsCRP is a separate test.
OxLDL is a separate test
particle size can be obtained by nmr by Lipofit