Apolipoproteins as markers and managers of coronary risk

QJM. 2006 May;99(5):277-87. doi: 10.1093/qjmed/hcl027. Epub 2006 Feb 27.

Abstract

Coronary artery disease (CAD) is a major cause of morbidity and mortality in Western communities. Reliable indices of coronary risk assessment and targets for drug treatment are important to the management of patients. Although plasma LDL cholesterol is well established as a predictor of CAD, it may not be the best circulatory marker. Results from recent epidemiological studies and statin trials suggest that apolipoprotein B-100 (apoB), with or without apoA-I, is superior to LDL cholesterol in predicting coronary events. Measurements of apolipoproteins are internationally standardized, automated, cost-effective and more convenient and precise than those for LDL cholesterol. ApoB may also be preferable to the measurement of non-HDL cholesterol. Measurement of apolipoproteins (apoB and possibly apoA-I) should be routinely added to the routine lipid profile (cholesterol, triglycerides and high-density lipoprotein cholesterol) to assess the atherogenic potential of lipid disorders. This is particularly relevant to dyslipidaemias characterized by an elevation in plasma triglycerides. Apolipoproteins, especially apoB, could also replace the standard "lipid profile" as a target for therapy in at-risk patients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anticholesteremic Agents / therapeutic use
  • Apolipoprotein A-I / blood
  • Apolipoprotein B-100
  • Apolipoproteins / blood*
  • Apolipoproteins B / blood
  • Biomarkers / blood
  • Cholesterol / blood*
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / diagnosis*
  • Coronary Artery Disease / drug therapy
  • Female
  • Humans
  • Male
  • Risk Assessment

Substances

  • Anticholesteremic Agents
  • Apolipoprotein A-I
  • Apolipoprotein B-100
  • Apolipoproteins
  • Apolipoproteins B
  • Biomarkers
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Cholesterol