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Cited by 211Lipoproteins and Cardiovascular HealthClinical Laboratory Practices and Quality ControlDiabetes, Cardiovascular Risks, and Lipoproteins

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

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Langlois, Michel R., Nordestgaard, Børge G., Langsted, Anne, Chapman, M. John, Aakre, Kristin M., Baum, Hannsjörg, Borén, Jan, Bruckert, Eric +21 more·2020·Clinical Chemistry and Laboratory Medicine (CCLM)
DOI 10.1515/cclm-2019-1253
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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 (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDLC), LDL cholesterol (LDLC), and calculated non-HDLC (=total – HDLC) constitute the primary lipid panel for estimating risk of atherosclerotic cardiovascular disease (ASCVD) and can be measured in the nonfasting state. LDLC is the primary target of lipid-lowering therapies. For on-treatment follow-up, LDLC shall be measured or calculated by the same method to attenuate errors in treatment decisions due to marked between-method variations. Lipoprotein(a) [Lp(a)]-cholesterol is part of measured or calculated LDLC and should be estimated at least once in all patients at risk of ASCVD, especially in those whose LDLC declines poorly upon statin treatment. Residual risk of ASCVD even under optimal LDL-lowering treatment should be also assessed by non-HDLC or apolipoprotein B (apoB), especially in patients with mild-to-moderate hypertriglyceridemia (2–10 mmol/L). Non-HDLC includes the assessment of remnant lipoprotein cholesterol and shall be reported in all standard lipid panels. Additional apoB measurement can detect elevated LDL particle (LDLP) numbers often unidentified on the basis of LDLC 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.

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  • apoB can be measured more accurately, more precisely, and more selectively than LDL-C or non-HDL-C.

    “Taken together with the evidence that apoB can be measured more accurately, more precisely, and more selectively than LDL-C or non-HDL-C,1,29–31”

    From Discordance among apoB, non-high-density lipoprotein cholesterol, and triglycerides: implications for cardiovascular prevention (2024) · cites this paper as [31]

    The Apolipoprotein B section says apoB is a clearly defined measurand and that its assays have the potential to meet accuracy and other analytical criteria that LDL-C and non-HDL-C measurements cannot meet. Recommendation VI also calls apoB measurement superior for assessing atherogenic particle numbers. The paper does not establish the claimed comparative precision, and it describes accuracy as a potential rather than an unqualified current advantage. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

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Research works printed but not linked: 53

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Authors
Langlois, M. R., Nordestgaard, B. G., 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
  • Ghent University (BE)
  • University of Copenhagen (DK)
  • Inserm (FR)
  • Haukeland University Hospital (NO)
  • Klinikum Ludwigsburg (DE)
  • Sahlgrenska University Hospital (SE)
  • Department of Endocrinology and Prevention of Cardiovascular Disease , Pitié-Salpetriere University Hospital , Paris , France
  • 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)
  • Institute for Clinical Chemistry , University Hospital Zurich , Zurich , Switzerland
  • Kantonspital Aarau AG, Institute for Laboratory Medicine , Aarau , Switzerland
  • 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)
  • Libertas International University , Zagreb , Croatia
  • Department of Laboratory Medicine, Collegium Medicum , NC University , Bydgoszcz , Poland
  • The University of Western Australia (AU)
  • Helsinki University Hospital (FI)
Corresponding author
Langlois, Michel R.
ORCID
Venue
Clinical Chemistry and Laboratory Medicine (CCLM)
Publisher
Walter de Gruyter GmbH
Published
2019-12-19
Volume
58
Issue
4
Pages
496-517
ISSN
  • 1434-6621 (ISSN-L)
  • 1437-4331
DOI
10.1515/cclm-2019-1253
OpenAlex
W4237223373
Cited by
211
References
44
Citations by year
2026: 30 · 2025: 21 · 2024: 34 · 2023: 50 · 2022: 31 · 2021: 24 · 2020: 21
FWCI
18.16
Type
journal article
Language
en
Open access
Locations
  • Clinical Chemistry and Laboratory Medicine (CCLM) (publishedVersion)
  • UWA Profiles and Research Repository (UWA) (publishedVersion, other-oa)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, other-oa)
  • St George's Online Research Archive (St George's University of London) (acceptedVersion)
  • Leiden Repository (Leiden University) (submittedVersion, cc-by-nc-nd)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion, cc-by-nc-nd)
  • HAL (submittedVersion)
  • DIAL (Catholic University of Leuven) (submittedVersion, other-oa)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
atherogenic lipoproteins, lipid-lowering therapy, LDL cholesterol, apolipoprotein B, lipoprotein(a), remnant cholesterol, atherosclerotic cardiovascular disease risk, hypertriglyceridemia, residual cardiovascular risk, reference values, laboratory diagnosis
MeSH terms
Pre-Analytical Phase, Apolipoproteins B, Humans, Cholesterol, HDL, Cholesterol, LDL, Societies, Medical, Biomarkers, Lipoprotein(a), Hydroxymethylglutaryl-CoA Reductase Inhibitors, Consensus, Atherosclerosis

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