The laboratory test results for lipids, Lp(a), homocysteine and LDL subparticles are shown in Table 1.
|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
|Total triglyceride||376 mg/dL||Normal < 200 mg/dL
Borderline high 200-400 mg/dL
Very high > 1000 mg/dL
|LDL cholesterol||120 mg/dL N||Desirable < 130 mg/dL
Borderline high risk 130 - 159 mg/dL
High risk > 160 mg/dL
|HDL cholesterol||28 mg/dL||Desirable > 60 mg/dL
Moderate risk 35 - 39 mg/dL
High risk < 35 mg/dL
|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
|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). The high-density lipoprotein result was low and triglycerides were borderline high (based on NCEP recommendations for triglyceride measurements ). 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.