Clinical utility of inflammatory markers and advanced lipoprotein testing: Advice from an expert panel of lipid specialists

Davidson, Michael H.; Ballantyne, Christie M.; Jacobson, Terry A.; Bittner, Vera A.; Braun, Lynne T.; Brown, Alan S.; Brown, W.Virgil; Cromwell, William C.; Goldberg, Ronald B.; McKenney, James M.; Remaley, Alan T.; Sniderman, Allan D.; Toth, Peter P.; Tsimikas, Sotirios; Ziajka, Paul E.; Maki, Kevin C.; Dicklin, Mary R.

doi:10.1016/j.jacl.2011.07.005

Cited by 262Lipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and LipoproteinsCholesterol and Lipid Metabolism

Clinical utility of inflammatory markers and advanced lipoprotein testing: Advice from an expert panel of lipid specialists

Davidson, Michael H., Ballantyne, Christie M., Jacobson, Terry A., Bittner, Vera A., Braun, Lynne T., Brown, Alan S., Brown, W.Virgil, Cromwell, William C. +9 more·2011·Journal of Clinical Lipidology

DOI 10.1016/j.jacl.2011.07.005

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Abstract

The National Cholesterol Education Program Adult Treatment Panel guidelines have established low-density lipoprotein cholesterol (LDL-C) treatment goals, and secondary non-high-density lipoprotein (HDL)-C treatment goals for persons with hypertriglyceridemia. The use of lipid-lowering therapies, particularly statins, to achieve these goals has reduced cardiovascular disease (CVD) morbidity and mortality; however, significant residual risk for events remains. This, combined with the rising prevalence of obesity, which has shifted the risk profile of the population toward patients in whom LDL-C is less predictive of CVD events (metabolic syndrome, low HDL-C, elevated triglycerides), has increased interest in the clinical use of inflammatory and lipid biomarker assessments. Furthermore, the cost effectiveness of pharmacological intervention for both the initiation of therapy and the intensification of therapy has been enhanced by the availability of a variety of generic statins. This report describes the consensus view of an expert panel convened by the National Lipid Association to evaluate the use of selected biomarkers [C-reactive protein, lipoprotein-associated phospholipase A(2), apolipoprotein B, LDL particle concentration, lipoprotein(a), and LDL and HDL subfractions] to improve risk assessment, or to adjust therapy. These panel recommendations are intended to provide practical advice to clinicians who wrestle with the challenges of identifying the patients who are most likely to benefit from therapy, or intensification of therapy, to provide the optimum protection from CV risk.

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LDL-C subfractions directly related to cardiovascular events are smaller, denser LDL particles.
“LDL-C subfractions that directly related to cardiovascular events are smaller, denser LDL particles [38].”
From Effects of aerobic exercise on lipids and lipoproteins (2017) · cites this paper as [38]

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Consensus Panel Recommendation for Incorporating Lipoprotein-Associated Phospholipase A2 Testing into Cardiovascular Disease Risk Assessment Guidelines
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Prognostic Utility of ApoB/AI, Total Cholesterol/HDL, Non-HDL Cholesterol, or hs-CRP as Predictors of Clinical Risk in Patients Receiving Statin Therapy After Acute Coronary Syndromes
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Improving Prediction of Ischemic Cardiovascular Disease in the General Population Using Apolipoprotein B
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The JUPITER Trial
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The Reduction of Inflammatory Biomarkers by Statin, Fibrate, and Combination Therapy Among Diabetic Patients With Mixed Dyslipidemia
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Lipoprotein(a) impairs generation of plasmin by fibrin-bound tissue-type plasminogen activator. In vitro studies in a plasma milieu.
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Reliability of low-density lipoprotein cholesterol, non-high density lipoprotein cholesterol, and apolipoprotein B measurement
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Differential Effect of Hypolipidemic Drugs on Lipoprotein-Associated Phospholipase A 2
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Diagnosis and treatment of apolipoprotein B dyslipoproteinemias
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Differential response of cholesterol and particle measures of atherogenic lipoproteins to LDL-lowering therapy: implications for clinical practice
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Effects of Atorvastatin Versus Other Statins on Fasting and Postprandial C-Reactive Protein and Lipoprotein-Associated Phospholipase A2 in Patients With Coronary Heart Disease Versus Control Subjects
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Apolipoprotein B and non-high density lipoprotein cholesterol and the risk of coronary heart disease in Chinese
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Lipoprotein(a), Hormone Replacement Therapy, and Risk of Future Cardiovascular Events
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Relationships between lipoprotein components and risk of myocardial infarction: age, gender and short versus longer follow-up periods in the Apolipoprotein MOrtality RISk study (AMORIS)
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Disparate LDL Phenotypic Classification among 4 Different Methods Assessing LDL Particle Characteristics
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Modification of apolipoprotein(a) lysine binding site reduces atherosclerosis in transgenic mice.
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A proposal to redefine familial combined hyperlipidaemia – Third workshop on FCHL held in Barcelona from 3 to 5 May 2001, during the Scientific Sessions of the European Society for Clinical Investigation
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Advanced Lipoprotein Testing and Subfractionation Are Clinically Useful
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CRP is a novel ligand for the oxidized LDL receptor LOX-1
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Inflammatory markers, cholesterol and statins: pathophysiological role and clinical importance
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Clinical Significance of Statin Pleiotropic Effects
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Heterogeneity of Low-Density Lipoprotein Particle Number in Patients With Type 2 Diabetes Mellitus and Low-Density Lipoprotein Cholesterol <100 mg/dl
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Lipoprotein-Associated Phospholipase A2 and Risk of Stroke
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Comparability of methods for LDL subfraction determination: A systematic review
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MEASUREMENT OF C-REACTIVE PROTEIN FOR THE TARGETING OF STATIN THERAPY IN THE PRIMARY PREVENTION OF ACUTE CORONARY EVENTS
Idker, P. A. M. R., Ifai, N. A. R., Learfield, M. I. C., Owns, O. R. D., Eis, E., Iles, J. S. H. M., Otto, M., & Orce, A. I. F. (2001) · Cited by 62 · see citing works
Clinical Lipidology: A Companion to Braunwald's Heart Disease
Ballantyne, C. M. (2014) · Cited by 61 · see citing works
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A Test in Context: Lipoprotein(a)
Tsimikas, S. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2016.11.042 · Cited by 1,137 · see citing works
“National Lipid Association provided similar recommendations on testing (48).”
MethodSelf-citation
Obesity, adiposity, and dyslipidemia: a consensus statement from the National Lipid Association
Bays, H. E., Toth, P. P., Kris-Etherton, P. M., Abate, N., Aronne, L. J., Brown, W. V., Gonzalez-Campoy, J. M., Jones, S. R., Kumar, R., La Forge, R., et al. (2013) · Journal of Clinical Lipidology · doi:10.1016/j.jacl.2013.04.001 · Cited by 521 · see citing works
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Effects of aerobic exercise on lipids and lipoproteins
Wang, Y., & Xu, D. (2017) · Lipids in Health and Disease · doi:10.1186/s12944-017-0515-5 · Cited by 436 · see citing works
Discrimination and Net Reclassification of Cardiovascular Risk With Lipoprotein(a)
Willeit, P., Kiechl, S., Kronenberg, F., Witztum, J. L., Santer, P., Mayr, M., Xu, Q., Mayr, A., Willeit, J., & Tsimikas, S. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.03.061 · Cited by 286 · see citing works
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Lipid-altering efficacy of ezetimibe plus statin and statin monotherapy and identification of factors associated with treatment response: A pooled analysis of over 21,000 subjects from 27 clinical trials
Morrone, D., Weintraub, W. S., Toth, P. P., Hanson, M. E., Lowe, R. S., Lin, J., Shah, A. K., & Tershakovec, A. M. (2012) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2012.02.016 · Cited by 263 · see citing works
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Genetics and causality of triglyceride-rich lipoproteins in atherosclerotic cardiovascular disease
Rosenson, R. S., Davidson, M. H., Hirsh, B. J., Kathiresan, S., & Gaudet, D. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.09.042 · Cited by 260 · see citing works
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Quantifying Atherogenic Lipoproteins: Current and Future Challenges in the Era of Personalized Medicine and Very Low Concentrations of LDL Cholesterol. A Consensus Statement from EAS and EFLM
Langlois, M. R., Chapman, M. J., Cobbaert, C., Mora, S., Remaley, A. T., Ros, E., Watts, G. F., Borén, J., Baum, H., Bruckert, E., et al. (2018) · Clinical Chemistry · doi:10.1373/clinchem.2018.287037 · Cited by 260 · see citing works
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Discordance of low-density lipoprotein (LDL) cholesterol with alternative LDL-related measures and future coronary events
Mora, S., Buring, J. E., & Ridker, P. M. (2014) · Circulation · doi:10.1161/circulationaha.113.005873 · Cited by 255 · see citing works
2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia
Blumenthal, R. S., Morris, P. B., Gaudino, M., Johnson, H. M., Anderson, T. S., Bittner, V. A., Blankstein, R., Brewer, L. C., Cho, L., de Ferranti, S. D., et al. (2026) · JACC · doi:10.1016/j.jacc.2025.11.016 · Cited by 304 · see citing works
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Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes
Saslow, L. R., Daubenmier, J. J., Moskowitz, J. T., Kim, S., Murphy, E. J., Phinney, S. D., Ploutz-Snyder, R., Goldman, V., Cox, R. M., Mason, A. E., et al. (2017) · Nutrition & Diabetes · doi:10.1038/s41387-017-0006-9 · Cited by 241 · see citing works
Omega-3 free fatty acids for the treatment of severe hypertriglyceridemia: The EpanoVa fOr Lowering Very high triglyceridEs (EVOLVE) trial
Kastelein, J. J. P., Maki, K. C., Susekov, A., Ezhov, M., Nordestgaard, B. G., Machielse, B. N., Kling, D., & Davidson, M. H. (2014) · Journal of Clinical Lipidology · doi:10.1016/j.jacl.2013.10.003 · Cited by 233 · see citing works
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From Lipids to Inflammation: New Approaches to Reducing Atherosclerotic Risk
Shapiro, M. D., & Fazio, S. (2016) · Circulation Research · doi:10.1161/circresaha.115.306471 · Cited by 217 · see citing works
How do we improve patient compliance and adherence to long-term statin therapy?
Maningat, P., Gordon, B. R., & Breslow, J. L. (2013) · Current Atherosclerosis Reports · doi:10.1007/s11883-012-0291-7 · Cited by 208 · see citing works
The Biological Role of Inflammation in Atherosclerosis
Wong, B. W., Meredith, A., Lin, D., & McManus, B. M. (2012) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2012.06.023 · Cited by 168 · see citing works
Icosapent Ethyl, a Pure Ethyl Ester of Eicosapentaenoic Acid: Effects on Circulating Markers of Inflammation from the MARINE and ANCHOR Studies
Bays, H. E., Ballantyne, C. M., Braeckman, R. A., Stirtan, W. G., & Soni, P. N. (2013) · American Journal of Cardiovascular Drugs · doi:10.1007/s40256-012-0002-3 · Cited by 141 · see citing works
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National lipid association annual summary of clinical lipidology 2016
Bays, H. E., Jones, P. H., Orringer, C. E., Brown, W. V., & Jacobson, T. A. (2016) · Journal of Clinical Lipidology · doi:10.1016/j.jacl.2015.08.002 · Cited by 128 · see citing works
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Association of apolipoprotein B and nuclear magnetic resonance spectroscopy-derived LDL particle number with outcomes in 25 clinical studies: assessment by the AACC Lipoprotein and Vascular Diseases Division Working Group on Best Practices
Cole, T. G., Contois, J. H., Csako, G., McConnell, J. P., Remaley, A. T., Devaraj, S., Hoefner, D. M., Mallory, T., Sethi, A. A., & Warnick, G. R. (2013) · Clinical Chemistry · doi:10.1373/clinchem.2012.196733 · Cited by 122 · see citing works
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2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
Writing Committee Members, Blumenthal, R. S., Morris, P. B., Gaudino, M., Johnson, H. M., Anderson, T. S., Bittner, V. A., Blankstein, R., Brewer, L. C., Cho, L., et al. (2026) · Circulation · doi:10.1161/cir.0000000000001423 · Cited by 122 · see citing works
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Demystifying the management of hypertriglyceridaemia
Watts, G. F., Ooi, E. M. M., & Chan, D. C. (2013) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2013.140 · Cited by 115 · see citing works
Icosapent ethyl, a pure EPA omega-3 fatty acid: Effects on lipoprotein particle concentration and size in patients with very high triglyceride levels (the MARINE study)
Bays, H. E., Braeckman, R. A., Ballantyne, C. M., Kastelein, J. J., Otvos, J. D., Stirtan, W. G., & Soni, P. N. (2012) · Journal of clinical lipidology · doi:10.1016/j.jacl.2012.07.001 · Cited by 94 · see citing works
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Treatment options for the management of hypertriglyceridemia: strategies based on the best-available evidence
Maki, K. C., Bays, H. E., & Dicklin, M. R. (2012) · Journal of Clinical Lipidology · doi:10.1016/j.jacl.2012.04.003 · Cited by 83 · see citing works
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Clinical impact of direct HDLc and LDLc method bias in hypertriglyceridemia. A simulation study of the EAS-EFLM Collaborative Project Group
Langlois, M. R., Descamps, O. S., van der Laarse, A., Weykamp, C., Baum, H., Pulkki, K., von Eckardstein, A., De Bacquer, D., Borén, J., Wiklund, O., et al. (2014) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2013.12.016 · Cited by 72 · see citing works
Lipoprotein Biomarkers and Risk of Cardiovascular Disease: A Laboratory Medicine Best Practices (LMBP) Systematic Review
Sandhu, P. K., Musaad, S. M. A., Remaley, A. T., Buehler, S. S., Strider, S., Derzon, J. H., Vesper, H. W., Ranne, A., Shaw, C. S., & Christenson, R. H. (2016) · The Journal of Applied Laboratory Medicine · doi:10.1373/jalm.2016.021006 · Cited by 55 · see citing works
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Effects of icosapent ethyl on lipoprotein particle concentration and size in statin-treated patients with persistent high triglycerides (the ANCHOR Study)
Ballantyne, C. M., Braeckman, R. A., Bays, H. E., Kastelein, J. J., Otvos, J. D., Stirtan, W. G., Doyle, R. T., Soni, P. N., & Juliano, R. A. (2015) · Journal of Clinical Lipidology · doi:10.1016/j.jacl.2014.11.009 · Cited by 46 · see citing works
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Advanced lipoprotein testing for cardiovascular diseases risk assessment: a review of the novel approaches in lipoprotein profiling
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Authors: Davidson, M. H., Ballantyne, C. M., Jacobson, T. A., Bittner, V. A., Braun, L. T., Brown, A. S., Brown, W. V., Cromwell, W. C., Goldberg, R. B., McKenney, J. M., Remaley, A. T., Sniderman, A. D., Toth, P. P., Tsimikas, S., Ziajka, P. E., Maki, K. C., & Dicklin, M. R.
Affiliations: University of Chicago (US)
Baylor College of Medicine (US)
Emory University (US)
University of Alabama at Birmingham (US)
Rush University Medical Center (US)
Loyola University Chicago (US)
Wake Forest University Health Sciences (US)
University of Miami (US)
Virginia Commonwealth University (US)
National Institutes of Health (US)
McGill University (CA)
University of California San Diego (US)
Corresponding author: Davidson, Michael H.
ORCID: Davidson, Michael H.
Ballantyne, Christie M.
Jacobson, Terry A.
Bittner, Vera A.
Braun, Lynne T.
Brown, Alan S.
Brown, W.Virgil
Cromwell, William C.
Goldberg, Ronald B.
Remaley, Alan T.
Sniderman, Allan D.
Toth, Peter P.
Tsimikas, Sotirios
Maki, Kevin C.
Venue: Journal of Clinical Lipidology
Publisher: Elsevier BV
Published: 2011-09
Volume: 5
Issue: 5
Pages: 338-367
ISSN: 1876-4789 (ISSN-L)
1933-2874
DOI: 10.1016/j.jacl.2011.07.005
OpenAlex: W1990092121
Cited by: 262
References: 234
Citations by year: 2026: 4 · 2025: 5 · 2024: 5 · 2023: 8 · 2022: 10 · 2021: 6 · 2020: 16 · 2019: 14 · 2018: 10 · 2017: 22 · 2016: 30 · 2015: 26 · 2014: 31 · 2013: 43 · 2012: 29
FWCI: 34.01
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Journal of clinical lipidology (publishedVersion)
PubMed (publishedVersion)
Funders: Abbott Laboratories
Pfizer
AstraZeneca
Genzyme
Merck
National Institutes of Health
National Lipid Association
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: inflammatory markers, C-reactive protein, lipoprotein-associated phospholipase A2, apolipoprotein B, lipoprotein(a), HDL subfractions, LDL subfractions, residual cardiovascular risk, hypertriglyceridemia, secondary prevention, metabolic syndrome, obesity, cardiovascular risk assessment, treatment goals
MeSH terms: Cardiovascular Diseases, Humans, Hypercholesterolemia, Cholesterol, LDL, Biomarkers, Practice Guidelines as Topic, Risk Assessment, Hydroxymethylglutaryl-CoA Reductase Inhibitors

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Clinical utility of inflammatory markers and advanced lipoprotein testing: Advice from an expert panel of lipid specialists

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