Beyond low-density lipoprotein cholesterol. A perspective on low high-density lipoprotein disorders and Lp(a) lipoprotein excess.

Evidence supports the involvement of 2 common dyslipidemias---low high-density lipoprotein disorders and Lp(a) lipoprotein excess--in coronary heart disease. Until clinical trials determine whether specific therapeutic interventions can prevent the occurrence and recurrence of coronary heart disease in patients with these dyslipidemias, the implementation of cholesterol-lowering guidelines can provide a reasonable way to manage low high-density lipoprotein disorders and to identify specific categories of patients who may be at particularly high risk for premature coronary heart disease. Empiric treatment guidelines are suggested for low high-density lipoprotein disorders and Lp(a) lipoprotein excess in order to foster further discussion and validation by clinical trial data.