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Cited by 115Lipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and LipoproteinsLipid metabolism and disorders

Role of apolipoprotein B in the clinical management of cardiovascular risk in adults: An Expert Clinical Consensus from the National Lipid Association

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Soffer, Daniel E., Marston, Nicholas A., Maki, Kevin C., Jacobson, Terry A., Bittner, Vera A., Peña, Jessica M., Thanassoulis, George, Martin, Seth S. +5 more·2024·Journal of Clinical Lipidology
DOI 10.1016/j.jacl.2024.08.013PMC PMC11734832
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Abstract

This National Lipid Association (NLA) Expert Clinical Consensus provides an overview of the physiologic and clinical considerations regarding the role of apolipoprotein B (apoB) measurement to guide clinical care based on the available scientific evidence and expert opinion. ApoB represents the total concentration of atherogenic lipoprotein particles in the circulation and more accurately reflects the atherogenic burden of lipoproteins when compared to low-density lipoprotein cholesterol (LDL-C). ApoB is a validated clinical measurement that augments the information found in a standard lipoprotein lipid panel; therefore, there is clinical value in using apoB in conjunction with a standard lipoprotein lipid profile when assessing risk and managing lipid-lowering therapy (LLT). ApoB has been shown to be superior to LDL-C in risk assessment both before and during treatment with LLT. In individuals, there can be discordance between levels of LDL-C and apoB, as well as LDL-C and non-high-density lipoprotein cholesterol (non-HDL-C), despite high levels of population-wide correlation. When there is discordance between LDL-C and apoB, or LDL-C and non-HDL-C, atherosclerotic cardiovascular disease risk generally aligns better with apoB or non-HDL-C. Additionally, apoB can be used in tandem with standard lipoprotein lipid measurements to diagnose distinct lipoprotein phenotypes. ApoB testing can inform clinical prognosis and care, as well as enable family cascade screening, when an inherited lipoprotein syndrome is identified. The NLA and other organizations will continue to educate clinicians about the role of apoB measurement in improving clinical risk assessment and dyslipidemia management. An urgent need exists to improve access and reimbursement for apoB testing.

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  • ApoB more directly reflects the number of circulating atherogenic particles than LDL-C alone, particularly when cholesterol content per particle varies, and provides a biologically relevant marker of treatment effect for therapies targeting the PCSK9 LDL receptor pathway.

    “ApoB more directly reflects the number of circulating atherogenic particles than LDL-C alone, particularly when cholesterol content per particle varies, and thus provides a biologically relevant marker of treatment effect for therapies targeting the PCSK9 LDL receptor pathway [15,16].”

    From Oral PCSK9 inhibitors for elevated LDL-C: A systematic review and meta-analysis of randomized trials (2026) · cites this paper as [15]

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Authors
Soffer, D. E., Marston, N. A., Maki, K. C., Jacobson, T. A., Bittner, V. A., Peña, J. M., Thanassoulis, G., Martin, S. S., Kirkpatrick, C. F., Virani, S. S., Dixon, D. L., Ballantyne, C. M., & Remaley, A. T.
Affiliations
  • University of Pennsylvania (US)
  • Brigham and Women's Hospital (US)
  • Indiana University Bloomington (US)
  • Emory University (US)
  • University of Alabama at Birmingham (US)
  • Weill Cornell Medicine (US)
  • McGill University Health Centre (CA)
  • Johns Hopkins University (US)
  • Idaho State University (US)
  • Aga Khan University (PK)
  • Virginia Commonwealth University (US)
  • Baylor College of Medicine (US)
  • National Institutes of Health (US)
Corresponding author
Soffer, Daniel E.
ORCID
Venue
Journal of Clinical Lipidology
Publisher
Elsevier BV
Published
2024-09
Volume
18
Issue
5
Pages
e647-e663
ISSN
  • 1876-4789 (ISSN-L)
  • 1933-2874
DOI
10.1016/j.jacl.2024.08.013
PMC
PMC11734832
OpenAlex
W4402280397
Cited by
115
References
18
Citations by year
2026: 68 · 2025: 43 · 2024: 4
FWCI
48.43
Type
journal article
Language
en
Open access
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  • Journal of clinical lipidology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Digital Commons-TMC (Texas Medical Center) (submittedVersion)
  • eCommons - AKU (Aga Khan University) (submittedVersion, cc-by-nc-nd)
Funders
  • U.S. Department of Veterans Affairs
  • American Heart Association
  • Amgen
  • Eli Lilly and Company
  • Pfizer
  • AstraZeneca
  • Sanofi
  • Gilead Sciences
  • Alnylam Pharmaceuticals
  • Pharmavite
  • Regeneron Pharmaceuticals
  • Ionis Pharmaceuticals
  • Amarin Corporation
  • Amryt Pharma
  • National Institute for Health and Care Research
  • Novo Nordisk
  • HLS Therapeutics
  • Esperion Therapeutics
  • National Institutes of Health
  • Genentech
  • NIH Clinical Center (Z01CL010303)
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
Keywords
apolipoprotein B, cardiovascular risk assessment, lipid-lowering therapy, LDL cholesterol, non-HDL cholesterol, lipoprotein phenotype, dyslipidemia management, atherosclerotic cardiovascular disease
MeSH terms
Heart Disease Risk Factors, Adult, Apolipoproteins B, Cardiovascular Diseases, Humans, Cholesterol, LDL, Risk Assessment, Consensus

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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