Document Detail


Apolipoprotein measurements: is more widespread use clinically indicated?
MedLine Citation:
PMID:  19743499     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Apolipoprotein (apo) B may be a more sensitive measure of atherogenicity than low-density lipoprotein cholesterol (LDL-C) and a better index for assessing cardiovascular risk. The refined risk assessment provided by apo B may be important in patients at high cardiometabolic risk such as those with diabetes mellitus or metabolic syndrome, as these conditions are often associated with normal LDL-C values but increased numbers of small, dense low-density lipoprotein (LDL) particles (indicating increased levels of apo B). Although apo B is not currently a treatment target in the United States cholesterol-lowering guidelines, a consensus conference endorsed by the American Diabetes Association and the American College of Cardiology recently recommended that apo B be added as a therapeutic target in patients at high cardiometabolic risk and in patients with clinical cardiovascular disease or diabetes. Suggested target goals are < 90 for high risk and < 80 mg/dL for highest risk patients. Current clinical data indicate that intensive statin therapy can lower apo B to meet this aggressive goal. While the proatherogenic/antiatherogenic ratio of apo B/apo A-I is a better risk discriminator than the single proatherogenic measurement (apo B), clinical trial data are lacking regarding the impact of increasing apo A-I and high-density lipoprotein on outcomes.
Authors:
Michael H Davidson
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical cardiology     Volume:  32     ISSN:  1932-8737     ISO Abbreviation:  Clin Cardiol     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-16     Completed Date:  2009-11-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  482-6     Citation Subset:  IM    
Copyright Information:
Copyright 2009 Wiley Periodicals, Inc.
Affiliation:
Preventive Cardiology Center, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA. michaeldavidson@radiantresearch.com
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MeSH Terms
Descriptor/Qualifier:
Apolipoprotein A-I / blood*
Apolipoproteins B / blood*
Atherosclerosis / blood*,  complications,  drug therapy
Biological Markers / blood
Cardiovascular Diseases / blood,  etiology*,  prevention & control
Cholesterol, HDL / blood
Cholesterol, LDL / blood
Diabetes Mellitus / blood
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
Metabolic Syndrome X / blood,  complications
Practice Guidelines as Topic
Predictive Value of Tests
Risk Assessment
Risk Factors
Chemical
Reg. No./Substance:
0/APOA1 protein, human; 0/Apolipoprotein A-I; 0/Apolipoproteins B; 0/Biological Markers; 0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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