Glossary

Clinical terminology used throughout The Sandusky Dyslipidemia Model.

Table of Contents

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ABI (Ankle-Brachial Index): Ratio of systolic blood pressure at the ankle to systolic blood pressure in the arm. ABI < 0.9 indicates peripheral arterial disease and is a risk enhancer.
ACL Inhibitor (ATP-Citrate Lyase Inhibitor): Drug class that inhibits cholesterol synthesis upstream of HMG-CoA reductase. Bempedoic acid is the only approved agent.
ACS (Acute Coronary Syndrome): Umbrella term for unstable angina, NSTEMI, and STEMI. Constitutes established ASCVD.
Agatston Score: Standard scoring method for coronary artery calcium based on area and density of calcified plaques on non-contrast CT.
ApoB (Apolipoprotein B): Protein present on every atherogenic lipoprotein particle (VLDL, IDL, LDL, Lp(a)). One ApoB molecule per particle; directly quantifies atherogenic particle number.
ASCVD (Atherosclerotic Cardiovascular Disease): Encompasses coronary heart disease, cerebrovascular disease, and peripheral arterial disease caused by atherosclerosis.

CAC (Coronary Artery Calcium): Measure of calcified atherosclerotic plaque in the coronary arteries, detected by non-contrast CT and quantified by Agatston score.
CABG (Coronary Artery Bypass Grafting): Surgical revascularization procedure for coronary artery disease.
CCTA (Coronary CT Angiography): CT imaging with intravenous contrast to visualize coronary artery anatomy and plaque.
CETP (Cholesteryl Ester Transfer Protein): Protein that transfers cholesteryl esters between lipoproteins. CETP inhibitors (e.g., obicetrapib) are investigational agents.
CKD-EPI: Chronic Kidney Disease Epidemiology Collaboration equation for estimating GFR from serum creatinine.
CVD (Cardiovascular Disease): Broad term encompassing ASCVD and heart failure. The PREVENT equations estimate total CVD risk.

De-risking: In this clinic, deferring statin therapy based on favorable risk markers. Permitted only when CAC = 0 AND ApoB is below the risk-appropriate target.
DLCN (Dutch Lipid Clinic Network) Score: Clinical scoring system for diagnosing familial hypercholesterolemia based on family history, clinical features, LDL-C level, and genetic testing.

eGFR (Estimated Glomerular Filtration Rate): Measure of kidney function calculated from serum creatinine using the CKD-EPI equation. Expressed as mL/min/1.73 m².

FH (Familial Hypercholesterolemia): Autosomal dominant genetic disorder of LDL metabolism causing markedly elevated LDL-C from birth. HeFH = heterozygous FH; HoFH = homozygous FH.

HbA1c (Glycated Hemoglobin): Measure of average blood glucose over the preceding 2–3 months. ≥ 6.5% indicates diabetes.
HDL-C (High-Density Lipoprotein Cholesterol): Cholesterol carried in HDL particles. Often called “good cholesterol.” Low levels are a risk marker but not a treatment target.
HeFH (Heterozygous Familial Hypercholesterolemia): One copy of the mutant gene; prevalence ~1:250. LDL-C typically 190–400 mg/dL untreated.
HMG-CoA Reductase: Rate-limiting enzyme in hepatic cholesterol synthesis. Target of statin medications.
HoFH (Homozygous Familial Hypercholesterolemia): Two copies of mutant gene(s); very rare (~1:300,000). LDL-C typically > 400 mg/dL untreated. Requires tertiary center referral.

LDL-C (Low-Density Lipoprotein Cholesterol): Cholesterol carried in LDL particles. Primary treatment target per guidelines.
LDL-P (LDL Particle Number): Total concentration of LDL particles measured by NMR spectroscopy. Correlates with ApoB.
Lp(a) (Lipoprotein(a)): Modified LDL particle with apolipoprotein(a) covalently bound to ApoB-100. Genetically determined; measured once per lifetime. Threshold ≥ 125 nmol/L indicates elevated ASCVD risk.
LP-IR (Lipoprotein Insulin Resistance Index): Composite NMR-derived score reflecting insulin resistance based on lipoprotein subclass patterns.

MACE (Major Adverse Cardiovascular Events): Composite endpoint in clinical trials typically including cardiovascular death, myocardial infarction, and stroke.
Metabolic Syndrome: Cluster of ≥ 3 of: central obesity, elevated triglycerides, low HDL-C, elevated blood pressure, elevated fasting glucose. Associated with insulin resistance and atherogenic dyslipidemia.

NMR LipoProfile: Labcorp nuclear magnetic resonance spectroscopy-based advanced lipid test that quantifies lipoprotein particle number, size, and subclass distribution.
Non-HDL-C: Total cholesterol minus HDL-C. Captures all atherogenic cholesterol (LDL + VLDL + IDL + Lp(a)). Secondary treatment target.
NPC1L1 (Niemann-Pick C1-Like 1): Intestinal cholesterol transporter. Target of ezetimibe.

PAD (Peripheral Arterial Disease): Atherosclerotic disease of the peripheral arteries (most commonly lower extremities). Constitutes established ASCVD.
PCI (Percutaneous Coronary Intervention): Catheter-based coronary revascularization (angioplasty/stenting).
PCSK9 (Proprotein Convertase Subtilisin/Kexin Type 9): Protein that promotes LDL receptor degradation. PCSK9 inhibitors (monoclonal antibodies: evolocumab, alirocumab; siRNA: inclisiran) reduce LDL-C by increasing LDL receptor recycling.
PREVENT (Predicting Risk of cardiovascular disease EVENTs): AHA risk prediction equations published in 2024 (Khan et al.) for estimating 10-year and 30-year total CVD risk.

Risk Enhancer: Clinical factor that, when present in a patient with borderline or intermediate calculated risk, favors more aggressive treatment. Defined by the 2026 ACC/AHA guidelines.

SAMS (Statin-Associated Muscle Symptoms): Muscle-related symptoms attributed to statin therapy, including myalgia, myopathy, and rarely rhabdomyolysis.
SAMS-CI (Statin-Associated Muscle Symptom Clinical Index): Validated scoring tool to assess the likelihood that muscle symptoms are attributable to statin therapy. Optional at this clinic.
SDI (Social Deprivation Index): Area-level measure of social deprivation based on census variables. Optional input for the PREVENT equations.
siRNA (Small Interfering RNA): RNA-based therapeutic that silences target gene expression. Inclisiran is an siRNA targeting hepatic PCSK9 mRNA.

TG (Triglycerides): Ester of glycerol and three fatty acids. Primary fat in adipose tissue and a major component of VLDL particles.
TIA (Transient Ischemic Attack): Temporary neurological deficit caused by focal cerebral ischemia without infarction.

UACR (Urine Albumin-to-Creatinine Ratio): Measure of albumin excretion in urine. Elevated UACR indicates kidney damage and is an optional PREVENT calculator input.

VLDL (Very Low-Density Lipoprotein): Triglyceride-rich lipoprotein produced by the liver. Precursor to IDL and LDL. Each VLDL particle carries one ApoB molecule.

Version	Date	Description
1.0.0	2026-03-30	Initial release