Cited by 157Lipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and LipoproteinsCholesterol and Lipid Metabolism

Non–High-Density Lipoprotein Cholesterol Versus Apolipoprotein B in Cardiovascular Risk Stratification

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Ramjee, Vimal, Sperling, Laurence S., Jacobson, Terry A.·2011·Journal of the American College of Cardiology

Abstract

With the emergence of new lipid risk markers and a growing cardiometabolic risk burden in the United States, there is a need to better integrate residual risk into cardiovascular disease (CVD) risk stratification. In anticipation of the Adult Treatment Panel IV (ATP IV) guidelines from the National Cholesterol Education Program (NCEP), there exists controversy regarding the comparative performance of the 2 foremost markers, apolipoprotein B (apoB) and non-high-density lipoprotein cholesterol (non-HDL-C), as they relate to the current standard of risk assessment and treatment: low-density lipoprotein cholesterol (LDL-C). Although some emerging markers may demonstrate better performance compared with LDL-C, certain fundamental characteristics intrinsic to a beneficial biomarker must be met prior to routine use. Collectively, studies have found that non-HDL-C and apoB perform better than LDL-C in CVD risk prediction, both on- and off-treatment, as well as in subclinical CVD risk prediction. The performance of non-HDL-C compared with apoB, however, has been a point of ongoing debate. Although both offer the practical benefits of accuracy independent of triglyceride level and prandial state, non-HDL-C proves to be the better marker of choice at this time, given established cutpoints with safe and achievable goals, no additional cost, and quick time to result with an easy mathematical calculation. The purpose of this review is to assess the performance of these parameters in this context and to discuss the considerations of implementation into clinical practice.

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Crossref · 10.1016/j.jacc.2011.05.009

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Authors
Ramjee, V., Sperling, L. S., & Jacobson, T. A.
Affiliations
Emory University (US)
Corresponding author
Jacobson, Terry A.
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2011-07
Volume
58
Issue
5
Pages
457-463
ISSN
0735-1097 (ISSN-L)
OpenAlex
W1571892311
Cited by
157
References
57
Citations by year
2026: 7 · 2025: 4 · 2024: 3 · 2023: 4 · 2022: 1 · 2021: 9 · 2020: 8 · 2019: 10 · 2018: 7 · 2017: 8 · 2016: 11 · 2015: 19 · 2014: 15 · 2013: 28 · 2012: 15
FWCI
3.75
Type
journal article
Language
en
Open access
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
Keywords
non-HDL cholesterol, apolipoprotein B, cardiovascular risk stratification, residual cardiovascular risk, LDL cholesterol
MeSH terms
Apolipoproteins B, Cardiovascular Diseases, Coronary Artery Disease, Humans, Lipoproteins, Biomarkers, Practice Guidelines as Topic, Risk Assessment

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