Cited by 246Lipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and LipoproteinsClinical Laboratory Practices and Quality Control

The DOI matches its Crossref record; 111 of the 111 references it cites were found in a registry or an index; 100 of the 160 sources its claims cite were checked for support.

Quantifying atherogenic lipoproteins for lipid-lowering strategies: Consensus-based recommendations from EAS and EFLM

Open access

Abstract

The joint consensus panel of the European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) recently addressed present and future challenges in the laboratory diagnostics of atherogenic lipoproteins. Total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, and calculated non-HDL cholesterol (=total - HDL cholesterol) constitute the primary lipid panel for estimating risk of atherosclerotic cardiovascular disease (ASCVD) and can be measured in the nonfasting state. LDL cholesterol is the primary target of lipid-lowering therapies. For on-treatment follow-up, LDL cholesterol shall be measured or calculated by the same method to attenuate errors in treatment decisions due to marked between-method variations. Lipoprotein(a)-cholesterol is part of measured or calculated LDL cholesterol and should be estimated at least once in all patients at risk of ASCVD, especially in those whose LDL cholesterol decline poorly upon statin treatment. Residual risk of ASCVD even under optimal LDL-lowering treatment should be also assessed by non-HDL cholesterol or apolipoprotein B, especially in patients with mild-to-moderate hypertriglyceridemia (2-10 mmol/L). Non-HDL cholesterol includes the assessment of remnant lipoprotein cholesterol and shall be reported in all standard lipid panels. Additional apolipoprotein B measurement can detect elevated LDL particle numbers often unidentified on the basis of LDL cholesterol alone. Reference intervals of lipids, lipoproteins, and apolipoproteins are reported for European men and women aged 20-100 years. However, laboratories shall flag abnormal lipid values with reference to therapeutic decision thresholds.

Overview

Integrity signals

Registry

Crossref · 10.1016/j.atherosclerosis.2019.12.005

Cites

111 of 111 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

44 Partly supported · 35 Supported · 32 No full text of the sources · 11 Sources not found · 8 Own interpretation · 3 Supported so far · 1 Not supported · 1 Couldn’t confirm · 1 Not checked yet · 1 No basis given · accuracy not yet measured

Show all 83 claims

  • It may state two separate claims as one. 41
  • Probably not a substantial claim. 18
  • The quote only partly states this claim. 1
54 of 54
  • The paper relies on this without support.

    ApoB assays currently provide the most accurate measurement of overall burden of atherogenic particles in the fasting and nonfasting state.

    “ApoB assays currently provide the most accurate measurement of overall burden of atherogenic particles in the fasting and nonfasting state.”
  • The authors state this as an assumption.

    The optimal VLDLC concentration associated with the fasting TG threshold 1.7 mmol/L is 0.8 mmol/L.

    “this value is based on the assumption that the”
  • The paper relies on this without support.

    dHDLC measurement errors in hypertriglyceridemic samples affect the calculation of non-HDLC.

    “However, dHDLC measurement errors in hypertriglyceridemic samples still affect the calculation of non-HDLC and most assays limit the measurement of dHDLC to TG < 10 mmol/L.”
  • The paper relies on this without support.

    Most dHDLC assays limit the measurement of dHDLC to TG < 10 mmol/L.

    “However, dHDLC measurement errors in hypertriglyceridemic samples still affect the calculation of non-HDLC and most assays limit the measurement of dHDLC to TG < 10 mmol/L.”
  • The paper relies on this without support.

    ApoB is a clearly defined measurand in contrast to the heterogeneous LDLC fraction.

    “In contrast to the heterogeneous LDLC fraction, apoB is a clearly defined measurand.”
  • The paper relies on this without support.

    ApoB quantification by automated immunoassays such as immunonephelometry and immunoturbidimetry can be easily implemented in clinical laboratories.

    “ApoB quantification by automated immunoassays such as immunonephelometry and immunoturbidimetry can be easily implemented in the clinical laboratories.”
  • The paper relies on this without support.

    Most nephelometric and turbidimetric apoB measurements are limited to TG < 10 mmol/L due to interference of light scattering or absorption caused by chylomicrons and large VLDLs.

    “Far higher than the maximum allowed TG concentration of 4.5 mmol/L for cLDLC, most nephelometric and turbidimetric apoB measurements are limited to TG < 10 mmol/L due to interference of light scattering or absorption caused by chylomicrons and large VLDLs;”
  • The paper relies on this without support.

    Implementation of apoB assays in follow-up of lipid-lowering therapies would impose healthcare systems and patients with yearly extra cost.

    “Implementation of apoB assays in follow-up of lipid-lowering therapies would impose healthcare systems and patients with yearly extra cost, although one might consider replacing the standard lipid profile (needed for calculation of LDLC and non-HDLC) by single follow-up measurement of apoB in order to attenuate the rise of expenses.”
  • The paper relies on this without support.

    Guideline-recommended LDLC thresholds are based on observations with Friedewald cLDLC using older HDLC precipitation methods which differ from dHDLC assays used nowadays.

    “Guideline-recommended LDLC thresholds are based on observations with Friedewald cLDLC using the older HDLC precipitation methods which differ from dHDLC assays used nowadays.”
  • The paper relies on this without support.

    Increased baseline glycerol concentrations can be found in patients with diabetes and chronic kidney disease and during intravenous lipid infusion, and TG may be wrongly flagged in these patients unless a glycerol-corrected TG assay is used.

    “Increased baseline glycerol concentrations can be found in patients with diabetes and chronic kidney disease and during intravenous lipid infusion, and TG may be wrongly flagged in these patients unless glycerol-corrected TG assay is used.”
  • The paper relies on this without support.

    There is no consensus on which threshold value in mmol/L to be used for Lp(a).

    “There is no consensus on which threshold value in mmol/L to be used for Lp(a); however, for conversion of Lp(a) concentrations in mg/dL to nmol/L, 13930 individuals from the Copenhagen General Population Study had measurements in both mg/dL and nmol/L by Denka Seiken assays distributed by Roche Diagnostics (Rotkreuz, Switzerland).”
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Percentages, sums and reported differences re-computed from the paper’s own numbers.

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Metadata

Authors
Nordestgaard, B. G., Langlois, M. R., Langsted, A., Chapman, M. J., Aakre, K. M., Baum, H., Borén, J., Bruckert, E., Catapano, A., Cobbaert, C., Collinson, P., Descamps, O. S., Duff, C. J., von Eckardstein, A., Hammerer-Lercher, A., Kamstrup, P. R., Kolovou, G., Kronenberg, F., Mora, S., Pulkki, K., Remaley, A. T., Rifai, N., Ros, E., Stankovic, S., Stavljenic-Rukavina, A., Sypniewska, G., Watts, G. F., Wiklund, O., & Laitinen, P.
Affiliations
  • University of Copenhagen (DK)
  • Ghent University (BE)
  • Inserm (FR)
  • Haukeland University Hospital (NO)
  • Klinikum Ludwigsburg (DE)
  • Sahlgrenska University Hospital (SE)
  • University of Milan (IT)
  • Leiden University Medical Center (NL)
  • St George's, University of London (GB)
  • Cliniques Universitaires Saint-Luc (BE)
  • University Hospitals of North Midlands NHS Trust (GB)
  • University Hospital Zurich (CH)
  • Onassis Cardiac Surgery Center (GR)
  • Innsbruck Medical University (AT)
  • Brigham and Women's Hospital (US)
  • University of Turku (FI)
  • National Institutes of Health (US)
  • Boston Children's Hospital (US)
  • Instituto de Salud Carlos III (ES)
  • Univerzitetski Klinički Centar Srbije (RS)
  • The University of Western Australia (AU)
  • Helsinki University Hospital (FI)
Corresponding author
  • Nordestgaard, Børge G.
  • Langlois, Michel R.
Venue
Atherosclerosis
Publisher
Elsevier BV
Published
2020-02
Volume
294
Pages
46-61
ISSN
0021-9150 (ISSN-L)
OpenAlex
W2996456596
Cited by
246
References
107
Citations by year
2026: 19 · 2025: 18 · 2024: 32 · 2023: 58 · 2022: 30 · 2021: 46 · 2020: 43
FWCI
28.66
Type
journal article
Language
en
Open access
Locations
  • Atherosclerosis (publishedVersion)
  • PubMed (publishedVersion)
  • Ghent University Academic Bibliography (Ghent University) (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, other-oa)
  • Leiden Repository (Leiden University) (submittedVersion, cc-by)
  • UWA Profiles and Research Repository (UWA) (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion, cc-by)
  • HAL (submittedVersion)
  • DIAL (Catholic University of Leuven) (submittedVersion, other-oa)
  • Työväentutkimus Vuosikirja (submittedVersion, other-oa)
  • St George's Online Research Archive (St George's University of London) (submittedVersion)
  • Leiden Repository (Leiden University) (submittedVersion, cc-by-nc-nd)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
  • Zurich Open Repository and Archive (University of Zurich)
Funders
Merck
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Health Professions › Medical Laboratory Technology › Clinical Laboratory Practices and Quality Control
Keywords
atherogenic lipoproteins, lipid-lowering therapy, LDL cholesterol, non-HDL cholesterol, HDL cholesterol, triglycerides, lipoprotein(a), apolipoprotein B, remnant cholesterol, atherosclerotic cardiovascular disease risk, hypertriglyceridemia, reference values, residual cardiovascular risk
MeSH terms
Hypolipidemic Agents, Humans, Hyperlipidemias, Lipoproteins, Atherosclerosis

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