Update on apolipoprotein B.
Journal
Current opinion in lipidology
ISSN: 1473-6535
Titre abrégé: Curr Opin Lipidol
Pays: England
ID NLM: 9010000
Informations de publication
Date de publication:
01 08 2021
01 08 2021
Historique:
pubmed:
20
4
2021
medline:
24
2
2022
entrez:
19
4
2021
Statut:
ppublish
Résumé
The 2019 European Society of Cardiology/European Atherosclerosis Society Guidelines concluded that apolipoprotein B (apoB) was a more accurate measure of cardiovascular risk and a better guide to the adequacy of lipid lowering than low-density lipoprotein cholesterol (LDL-C) or non-high-density lipoprotein cholesterol (HDL-C). Also, they stated that apoB can be measured more accurately than LDL-C or non-HDL-C. This strong endorsement of the central role of apoB contrasts with the limited endorsement of apoB by the 2018 American College of Cardiology/American Heart Association Multisociety Guidelines. Nevertheless, both retained LDL-C as the primary metric to guide statin/ezetimibe/Proprotein convertase subtilisin/kexin type 9 (PCSK9) therapy. This essay will review the most important recent advances in knowledge about apoB with particular emphasis on the results of Mendelian randomization studies and a new discordance analysis in subjects on statin therapy. We will also lay out why using LDL-C to guide the adequacy of lipid lowering therapy represents an interpretive error of the results of the statin/ezetimibe/PCSK9 inhibitor randomized clinical trials and therefore why apoB should be the primary metric to guide statin/ezetimibe/PCSK9 therapy. There is now a robust body of evidence demonstrating the superiority of apoB over LDL-C and non-HDL-C as a clinical marker of cardiovascular risk. LDL-C is not the appropriate marker to assess the benefits of statin/ezetimibe/PCSK9 therapy.
Identifiants
pubmed: 33870931
doi: 10.1097/MOL.0000000000000754
pii: 00041433-202108000-00004
doi:
Substances chimiques
Apolipoproteins B
0
Hydroxymethylglutaryl-CoA Reductase Inhibitors
0
Hypolipidemic Agents
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
226-230Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
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