What are the indications for apolipoprotein B (apoB) measurement?

Updated: Jul 08, 2021
  • Author: Georges Elhomsy, MD, ECNU, FACE; Chief Editor: Eric B Staros, MD  more...
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Answer

Answer

Incontestable data support the concept that apoB is a better tool to assess cardiovascular disease than LDL-C and non-HDL-C.

Furthermore, apoB seems to be a very important parameter in assessing cardiovascular risk in the setting of diabetes and metabolic syndrome, since patients with these conditions tend to have small, dense LDL particles with relatively normal LDL-C but high apoB levels.

In addition, several clinical trials have shown that apoB is a better marker for monitoring patients on statin therapy for residual risk than LDL-C. For example, a study by Johannesen et al indicated that in patients treated with statins, an association exists between high levels of apoB and non-HDL-C and greater residual risk of all-cause mortality and myocardial infarction. High LDL-C, however, was found to carry no such association. [8]

Finally, a Consensus Conference Report by the ADA/ACC has recommended the use of apoB level for risk assessment in persons at high risk for cardiometabolic disease.


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