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

Current Cardiology Reports volume 11, Article number: 468 (2009) Cite this article

Abstract

Managing low-density lipoprotein (LDL) is an integral part of clinical practice. What remains controversial is whether we are using the best measure of LDL quantity for this purpose. Historically, the cholesterol content of LDL particles (LDLC) has been used to express LDL quantity. However, because of variability in the cholesterol carried in LDL particles, frequent disagreement occurs between LDLC and particle measures of LDL quantity, including apolipoprotein B-100 (apo B) or nuclear magnetic resonance (NMR) LDL particle number (LDL-P). Studies consistently demonstrate apo B and LDL-P are superior predictors of coronary heart disease (CHD) risk and superior indicators of low CHD risk on lipid-lowering therapy. Recent recommendations advocate that, in addition to LDLC and non-high-density lipoprotein cholesterol, apo B (or NMR LDL-P) be used as a target of therapy. This article reviews the rationale supporting these recommendations and provides a model for integrating LDL particle measures in clinical practice.

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Affiliations

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

    William C. Cromwell

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  1. William C. Cromwell
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  2. Thomas A. Barringer
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Correspondence to William C. Cromwell.

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Cromwell, W.C., Barringer, T.A. Low-density lipoprotein and apolipoprotein B: Clinical use in patients with coronary heart disease. Curr Cardiol Rep 11, 468 (2009). https://doi.org/10.1007/s11886-009-0067-z

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  • DOI: https://doi.org/10.1007/s11886-009-0067-z

Keywords

  • Arterioscler Thromb Vasc Biol
  • Coronary Heart Disease Event
  • Framingham Offspring Study
  • LDLC Level
  • Quebec Cardiovascular Study