Apolipoprotein B Testing Recommended for Heart Patients

Low-density lipoprotein and non-high-density lipoprotein cholesterol tests less predictive of cardiovascular events, according to review

TUESDAY, Oct. 23 (HealthDay News) -- Apolipoprotein B is an effective indicator of low-density lipoprotein (LDL) particle numbers and should be tested in heart patients, along with the ratio of apolipoprotein B to apolipoprotein A-1, after other tests, researchers report in the Oct. 30 issue of the Journal of the American College of Cardiology.

James Mudd, M.D., of Johns Hopkins University in Baltimore, and colleagues reviewed studies of LDL and coronary artery disease that showed that curbing LDL in heart patients helps prevent new events. But most heart attacks occur despite aggressive treatment, possibly due to late treatment or other reasons.

The current standard involves curbing LDL levels by targeting LDL cholesterol. Measuring non-high-density lipoprotein (HDL) cholesterol is advised when triglyceride levels drop below 200 mg/dL. Most studies show that measuring apolipoprotein B is a better heart attack risk predictor than LDL cholesterol and non-HDL cholesterol. Other tests for LDL particles are not routinely advised.

"Because apolipoprotein B is a superior predictor of LDL particles, we recommend that apolipoprotein B and the apolipoprotein B/apolipoprotein A-1 ratio be determined after measurement of LDL cholesterol, non-HDL cholesterol, and the ratio of total cholesterol/HDL cholesterol to better predict coronary artery disease and assess efficacy of treatment," the authors write.

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