Apolipoproteins versus lipids as indices of coronary risk and as targets for statin treatment

• Published in: The Lancet (British edition) Vol. 361; no. 9359; pp. 777 - 780
• Main Authors: Sniderman, AD, Furberg, CD, Keech, A, van Lennep, JE Roeters, Frohlich, J, Jungner, I, Walldius, G
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-03-2003; Elsevier Limited
• Subjects: Anticholesteremic Agents - therapeutic use; Apolipoproteins; Apolipoproteins B - blood; Cholesterol; Cholesterol - blood; Cholesterol, LDL - blood; Coronary Artery Disease - blood; Coronary Artery Disease - drug therapy; Correlation coefficient; Health risk assessment; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Lipids; Low density lipoprotein; Medicin och hälsovetenskap; Proteins; Risk Factors; Statins; Canada; Quebec Canada
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(03)12663-3

ATPII has introduced non-HDL cholesterol as an alternative predictor to LDL cholesterol in patients with hypertriglyceridaemia.12 Because there is a good correlation between non-HDL cholesterol and apolipoprotein B, measurement of non-HDL cholesterol has been argued to be a substitute for measurement of apolipoprotein B.12 But correlation is only an approximate index of agreement between two variables. Considerable dispersion can arise above and below a line of identity, but still be a high correlation coefficient. That is the case for non-HDL cholesterol and apolipoprotein B. Moreover, to predict vascular events, on-treatment concentration of apolipoprotein B was superior to non-HDL-cholesterol in the Leiden Heart Study8 and in AFCAPS/TexCAPS.6 Apolipoprotein B was also better than non-HDL cholesterol to predict carotid intima media thickness in patients with familial combined hyperlipidaemia, which is the commonest familial atherogenic dyslipoproteinaemia and which is characterised by hypertriglyceridaemia and raised concentration of apolipoprotein B.16 In view of these results, non-HDL cholesterol does not seem to be an adequate surrogate for apolipoprotein B.