This the 3rd study I have posted questioning why LDL-C should be even in the question of risk - but rather focus on metabolic disease, for example, diabetes, insulin resistance, high blood pressure
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Purely anecdotal but I’ve observed this in the Lp(a) groups as well. People with high Lp(a) but normal or low LDL seem to be the ones having heart events.
Sadly, many people also receive their initial diagnosis of type 2 diabetes when hospitalized for a heart attack. Our sick care system is not set up to flag pre-diabetes.