Should apolipoprotein B replace LDL cholesterol as therapeutic targets are lowered?

Jeffrey W. Meeusen, Leslie J. Donato, Allan S. Jaffe

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations


Purpose of review The success of LDL cholesterol (LDL-C) as a predictor of atherosclerotic cardiovascular disease and a therapeutic target is indisputable. Apolipoprotein B (apoB) is a more contemporary and physiologically relevant measure of atherogenic lipoproteins. This report summarizes recent comparisons of apoB and LDL-C as biomarkers of cardiovascular risk. Recent findings Multiple recent reports have found that LDL-C methods perform poorly at low concentrations (<70mg/dl). Several meta-analyses from randomized controlled trials and large prospective observational studies have found that apoB and LDL-C provide equivalent information on risk of cardiovascular disease. More innovative analyses have asserted that apoB is a superior indicator of actual risk when apoB and LDL-C disagree. Summary ApoB is more analytically robust and standardized biomarker than LDL-C. Large population studies have found that apoB is at worst clinically equivalent to LDL-C and likely superior when disagreement exists. Realistically, many obstacles prevent the wide spread adoption of apoB and for now providers and their patients must weigh the costs and benefits of apoB.

Original languageEnglish (US)
Pages (from-to)359-366
Number of pages8
JournalCurrent opinion in lipidology
Issue number4
StatePublished - Aug 1 2016


  • atherosclerosis
  • biomarker
  • cardiovascular disease
  • lipoproteins

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Molecular Biology
  • Genetics
  • Nutrition and Dietetics
  • Cardiology and Cardiovascular Medicine
  • Cell Biology


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