Should Apolipoproteins Replace LDL and HDL for Cardiac Risk Assessment?

Apolipoproteins B (Apo B) and A1 (Apo A1) are the major protein constituents of LDL and HDL cholesterol, respectively. Although most guidelines recommend cardiovascular risk assessment based on LDL and HDL levels, several studies have shown that ApoB is a better predictor of cardiovascular disease than is LDL. As a result, a consensus report from the American Diabetes Association and the American College of Cardiology recently recommended that Apo B be used, along with LDL, to assess response to statin therapy in patients at high risk for diabetes, cardiovascular disease, or both.

In the INTERHEART study, 12,461 patients with acute myocardial infarction from the world’s major regions and ethnic groups were compared with 14,637 age- and sex-m…