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Low-density lipoprotein and apolipoprotein B: clinical use in patients with coronary heart disease

William C Cromwell1, Thomas A Barringer

  • 1Division of Atherosclerosis and Lipoprotein Disorders, Presbyterian Cardiovascular Institute, 125 Baldwin Avenue, Suite 200, Charlotte, NC 28204, USA. wcromwell@gmail.com

Current Cardiology Reports
|October 30, 2009
PubMed

Insights

Measuring low-density lipoprotein (LDL) cholesterol is key in practice. Apo B and LDL particle number are better predictors of coronary heart disease risk than LDL cholesterol alone.

Area of Science:

  • Cardiology
  • Clinical Lipidology
  • Preventive Medicine

Background:

  • Low-density lipoprotein (LDL) management is crucial in clinical practice.
  • Traditional LDL cholesterol (LDLC) measurement has limitations due to particle variability.
  • Discrepancies exist between LDLC and LDL particle measures like apolipoprotein B-100 (apo B) or NMR LDL particle number (LDL-P).

Purpose of the Study:

  • To review the rationale for using LDL particle measures in clinical practice.
  • To discuss the superiority of apo B and LDL-P in predicting coronary heart disease (CHD) risk.
  • To provide a model for integrating LDL particle measures into therapeutic strategies.

Main Methods:

  • Review of existing studies on LDL measurement and CHD risk prediction.
  • Analysis of the relationship between LDLC, apo B, and LDL-P.
  • Evaluation of current clinical recommendations regarding LDL targets.

Main Results:

  • Apo B and LDL-P are consistently superior predictors of CHD risk.
  • Apo B and LDL-P better indicate reduced CHD risk during lipid-lowering therapy.
  • Recent guidelines recommend apo B or LDL-P as therapeutic targets alongside LDLC.

Conclusions:

  • LDL particle measures, specifically apo B and LDL-P, offer superior risk assessment compared to LDLC.
  • Integrating LDL particle assessment into clinical practice is recommended for improved CHD risk management.
  • Further research may refine the clinical application of LDL particle-based therapies.

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