“๐๐ฝ๐ผ ๐ ๐ฉ๐ ๐๐๐”
By focusing only on LDL as the "chief villain" and ignoring ApoB, which accounts for all atherogenic particles (including LDL, Lp (a), triglyceride-rich remnants, and others), you are missing the bigger picture one out of every ten times in individuals at significant risk for cardiovascular vents
๐๐ก๐๐ญ ๐ข๐ฌ ๐๐ฉ๐จ๐ฅ๐ข๐ฉ๐จ๐ฉ๐ซ๐จ๐ญ๐๐ข๐ง ๐ (๐๐ฉ๐จ ๐)?
Apolipoprotein B (Apo B) is the main protein component of atherogenic lipoproteins like LDL, as well as all other Remnant particles (Lp (a) LDL, VLDL. etc.) which transport cholesterol in the blood. Apo B is the “driver” of “truck load” of LDL and other atherogenic particles that penetrates the endothelial barrier. ApoB is a more precise marker for tracking disease risk and therapy benefits than LDL-C or non-HDL-C. It can be measured accurately, quickly, and at a low cost. Even at major U.S. academic medical centers ApoB is ordered less than 1% as frequently as the standard lipid panel.
๐๐ก๐ฒ ๐๐ฌ ๐๐ฉ๐จ ๐ ๐๐จ๐ซ๐ ๐๐๐ฉ๐๐ง๐๐๐๐ฅ๐?
• ApoB levels indicate the number of LDL particles, which can better predict heart disease risk than LDL levels alone.
• ApoB is more strongly associated with heart attacks and strokes than LDL cholesterol.
• High ApoB levels can reveal dangerous small LDL particles not identified by LDL cholesterol levels.:
• ApoB better predicts heart risk in individuals with metabolic syndrome, type 2 diabetes, or familial hypercholesterolemia.
๐๐ก๐ฒ ๐ข๐ฌ ๐๐ก๐๐๐ค๐ข๐ง๐ ๐๐ฉ๐จ๐ฅ๐ข๐ฉ๐จ๐ฉ๐ซ๐จ๐ญ๐๐ข๐ง ๐ (๐๐ฉ๐จ ๐) ๐ง๐จ๐ญ ๐ฌ๐ญ๐๐ง๐๐๐ซ๐ ๐ฅ๐ข๐ค๐ ๐๐๐?
• “Old habits die hard." Apo B is a newer marker compared to LDL. Cholesterol became widely recognized in the 1950s, and LDL followed in the 1960s. Apo B was discovered in 1970, and its link to atherosclerosis gained attention in the 1980s. Early studies, like Framingham (1960) and MRFIT (1970), used LDL as the primary marker, establishing LDL as the focus. However, Apo B studies began later (e.g., PROCAM-1979, ARIC-1987, Quebec Cardiovascular Study 1989, Women’s Health Study 2000, Interheart-2000, Dallas Heart Study 2000, and the IMPROVE-IT study 2015), all of which demonstrated Apo B’s superiority over LDL.
๐๐ญ ๐ข๐ฌ ๐ญ๐ข๐ฆ๐ ๐ญ๐จ ๐จ๐ฏ๐๐ซ๐๐จ๐ฆ๐ ๐ญ๐ก๐ ๐ซ๐๐ฌ๐ข๐ฌ๐ญ๐๐ง๐๐ ๐๐ง๐ ๐ฌ๐ญ๐๐ซ๐ญ ๐ฆ๐๐๐ฌ๐ฎ๐ซ๐ข๐ง๐ ๐๐ฉ๐จ ๐ ๐ซ๐จ๐ฎ๐ญ๐ข๐ง๐๐ฅ๐ฒ ๐๐ฅ๐จ๐ง๐ ๐ฌ๐ข๐๐ ๐๐๐. ๐๐ญ ๐๐ง๐ญ๐๐ ๐ซ๐๐ญ๐๐ ๐๐๐๐ซ๐ญ ๐๐๐ง๐ญ๐๐ซ, ๐ฐ๐ ๐ซ๐จ๐ฎ๐ญ๐ข๐ง๐๐ฅ๐ฒ ๐๐ก๐๐๐ค ๐๐ง๐ ๐ฆ๐จ๐ง๐ข๐ญ๐จ๐ซ ๐๐ฉ๐จ๐ ๐ฅ๐๐ฏ๐๐ฅ๐ฌ. ๐๐ก๐ ๐ญ๐๐ซ๐ ๐๐ญ ๐๐ฉ๐จ๐ ๐ฅ๐๐ฏ๐๐ฅ ๐ข๐ฌ ๐ฅ๐๐ฌ๐ฌ ๐ญ๐ก๐๐ง ๐๐ ๐ฆ๐ /๐๐ ๐๐จ๐ซ ๐ก๐ข๐ ๐ก-๐ซ๐ข๐ฌ๐ค ๐ข๐ง๐๐ข๐ฏ๐ข๐๐ฎ๐๐ฅ๐ฌ ๐๐ง๐ ๐ฅ๐๐ฌ๐ฌ ๐ญ๐ก๐๐ง ๐๐ ๐ฆ๐ /๐๐ ๐๐จ๐ซ ๐ญ๐ก๐จ๐ฌ๐ ๐ฐ๐ข๐ญ๐ก ๐๐ฌ๐ญ๐๐๐ฅ๐ข๐ฌ๐ก๐๐ ๐ก๐๐๐ซ๐ญ ๐๐ข๐ฌ๐๐๐ฌ๐.
