Moreover, in the non-CABG population, the administration of these agents on top of statins has proven to be futile in recent Future research may help further explore this possible strategy of administering second-line agents such as fenofibrate to elevate low levels of HDL after surgery, with a view toward improving post-CABG vein graft patency. Triglyceride Management Although LDL remains the primary therapeutic target for hyperlipidemia, high triglyceride levels are also associated with an elevated risk of developing CAD.169,170 Elevated tri- glyceride levels are a marker of atherogenic remnant lipopro- teins, which are more easily oxidized, leading to increased Triglyceride levels >150 mg/dL tend to be associated with a greater burden of small and dense LDL, making the calculation of the LDL level with the Friedewald formula inaccurate. Therefore, using the non- HDL cholesterol level, defined as the difference between total cholesterol and HDL levels, has been suggested as a more accurate tool for risk and treatment assessment in the presence of high triglyceride levels. Non-HDL cholesterol includes all cholesterol present in lipoprotein particles con- sidered to be atherogenic, including LDL, lipoprotein(a), intermediate-density lipoprotein, and very-low-density lipo- In patients with hypertriglyceridemia, first-line thera- pies usually include diet modification, exercise, and weight loss, with a focus on restriction of refined carbohydrates and reduced alcohol intake, in association with increased intake of omega-3 fatty acids. Statins may be of benefit in lowering non-HDL cholesterol levels in patients with high triglycer- In an era before the routine use of statins, 2 placebo-controlled trials reported that gemfibrozil treatment caused marked reductions in triglyceride levels and increased HDL levels, leading to significant reduction in car- Because of the dangers associated with gemfibrozil,167,168 fenofibrate therapy has been the focus of more recent studies as a treatment option for dyslipidemia and elevated triglycer- ide levels. 