LDL Protein a More Accurate Indicator of Heart Risk

A study has found that measuring the amount of a protein called apoprotein B (apoB) is a more accurate and efficient test for the risk of heart disease than measuring cholesterol levels or computing the ratio of total cholesterol to high-density cholesterol (HDL). The study was published in the March 2003 issue of The Lancet.

Apoproteins are specialized transport proteins that carry lipids in the blood. Most of the cholesterol in blood is in low-density lipoprotein (LDL) particles, which differ in size. The smaller particles have less cholesterol but are associated the most with coronary artery disease. The value for apoB is a measurement of the total number of these artherogenic particles. In the study, researchers analyzed data from epidemiologic studies and clinical trials involving thousands of heart patients. They concluded that although measuring cholesterol the traditional way helps to determine the risk of heart disease, it is not very accurate. When they looked at data from patients who had lowered their cholesterol levels by using medications, they found that their apoB levels were still high, suggesting that these patients were still at risk of having a heart attack.

"Because apoproteins can be accurately and inexpensively measured in routine clinical laboratories, we suggest that this measurement should be brought into clinical practice,” said Dr. Allan Sniderman, first author and a cardiologist at the McGill University Health Center (MUHC, Montreal, Canada). "In addition, this test is considerably more convenient for the patients because fasting is not required.” Dr. Sniderman conducted the study in collaboration with colleagues from Australia, British Columbia, and The Netherlands.


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