doi: 10.1161/CIRCULATIONAHA.105.583336
(Circulation. 2005;112:3366-3367.)
© 2005 American Heart Association, Inc.
Editorial |
Apolipoprotein B Versus Non–High-Density Lipoprotein Cholesterol
And the Winner Is...
From the Mike Rosenbloom Laboratory for Cardiovascular Research, McGill University Health Centre, Montreal, Quebec, Canada.
Correspondence to Allan D. Sniderman, MD, Mike Rosenbloom Laboratory for Cardiovascular Research, Room H7.22, RVH–MUHC, 687 Pine Ave West, Montreal, QC H3A 1A1, Canada. E-mail allan.sniderman@hotmail.com
Key Words: Editorials • cholesterol • apolipoproteins • risk factors
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
Vascular disease is already the most common cause of death in the developed world and by 2020 will become the leading cause of death in the developing world as well.1 No society can afford to offer everyone every therapy. Accordingly, improving the identification of individuals at increased risk of cardiovascular disease to receive preventive therapy must be one of our highest priorities. The study by Pischon and colleagues,2 which appears in this issue of Circulation and which demonstrates that apolipoprotein B (apoB) is superior to non–high-density lipoprotein cholesterol (non–HDL-C) to identify the risk of vascular events, represents an important step forward in this process.
Article p 3375
In 2002, the Adult Treatment Panel III (ATP III) of the National Cholesterol Education Program reaffirmed their previous position, namely, that low-density lipoprotein cholesterol (LDL-C) would remain the cornerstone of lipid management. At the same time, they acknowledged the increased risk associated with hypertriglyceridemia and the metabolic syndrome and introduced non–HDL-C as a treatment target for this large group of patients.3 Use of apoB was not recommended. Rather, based on the fact that apoB and non–HDL-C are highly correlated (generally >0.85), they stated the 2 were equivalent in terms of risk prediction and non–HDL-C would be preferable because no additional test need be performed. The prestige of the ATP process and the fact that major payers such as Blue Cross Blue Shield used the ATP decision as a justification not to reimburse for apoB4 effectively excluded apoB from widespread clinical application.
Were they
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