Is there a better marker of cardiovascular risk than LDL cholesterol Apolipoproteins B and A-I – new risk factors and targets for therapy》.pdfVIP

Nutrition, Metabolism Cardiovascular Diseases (2007) 17, 565e571 /locate/nmcd VIEWPOINT Is there a better marker of cardiovascular risk than LDL cholesterol? Apolipoproteins B and A-I e new risk factors and targets for therapy ¨ a,b,*, Ingmar Jungner c,d Goran Walldius a King Gustaf V Research Institute, Karolinska Institute, Stockholm, Sweden b ¨ ¨ AstraZeneca, Sodertalje, Sweden c Department of Medicine, Karolinska Institute, Epidemiological Unit, Stockholm, Sweden d CALAB Research, Stockholm, Sweden Received 11 December 2006; received in revised form 16 February 2007; accepted 26 February 2007 KEYWORDS Abstract LDL (Low Density Lipoprotein) is considered the major atherogenic lipo- Cardiovascular risk; protein whereas HDL (High Density Lipoprotein) is anti-atherogenic. In recent years Myocardial infarction; also non-HDL cholesterol as well as TG (triglycerides) are included in guidelines de- Stroke; fining cardiovascular (CV) risk and target values during lipid lowering treatment. In LDL cholesterol; recent years apolipoproteins (apo) B, reflecting atherogenic, and apoA-I reflecting apoB; anti-atherogenic lipoproteins, have been shown to be superior to conventional apoA-I; lipids in predicting risk and reduction of events in lipid lowering trials using statins. apoB/apoA-I ratio These new data are reviewed. The apoB/apoA-I ratio, which reflects the choles- terol balance of the ‘‘bad’’ and ‘‘good’’ lipids, is a simple and accurate summary index of CV risk and it is better than the conventional LDL and other lipids as a risk