Dr. Vickie Beloy, DMSc, PA-C
The Centers for Diseases Control and Prevention (CDC) estimates that 12.6 million adults in the United States (US) are diagnosed with coronary heart disease. Current guidelines determine atherosclerotic cardiovascular disease (ASCVD) risk using traditional cholesterol assays measuring total cholesterol, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), and triglycerides. A review of the current literature suggests that immunoassays for apolipoprotein B (apoB) are superior to LDL-C in determining ASCVD risk and managing therapy. Traditional cholesterol assays estimate LDL-C using the Friedwald Equation, and studies show LDL-C discordance in patients with elevated triglycerides. Direct testing for atherogenic particles may lead to earlier detection and greater confidence of ASCVD risk, improving the discussion with patients to make a shared decision on lipid-lowering therapy. Laboratory testing for apoB is simple, cost-effective, and directly measures the particle responsible for developing plaque in the arterial wall. This article aims to evaluate the effectiveness of assessing serum levels of apoB as a better indicator of cardiovascular risk.
Daffon RB. Apolipoprotein B: The Search for a Better Method of Determining ASCVD Risk. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2023; 5(2).
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