It seems to me that the recent article by Cui et al1 demonstrating non–high-denisty lipoprotein cholesterol (HDL-C) to be a better predictor of cardiovascular disease (CVD) mortality than low-density lipoprotein cholesterol (LDL-C) was basically a reformulation of an already recognized phenomenon, namely, that a formula including HDL-C is superior to one neglecting it. Several authors have demonstrated that the ratio of total cholesterol (TC) to HDL-C is superior to LDL-C in predicting CVD.2-5 Ciu et al1 simply substitute the difference between TC and HDL-C for the ratio of the two; it is therefore not surprising that their value should also be superior to LDL-C.
Levitt JI. Prediction of Cardiovascular Mortality. Arch Intern Med. 2002;162(1):108. doi:
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