Targets for LDL-lowering therapy.
OBJECTIVE
To compare non-HDL-cholesterol (non-HDL-C) and apolipoprotein B (apoB) as targets for LDL-lowering therapy. The conventional approach is restricted to a comparison of in-trial data. Although essential, this overlooks the issue as to which marker better identifies residual risk after any particular treatment regimen.


RESULTS
Data from a series of recent studies, including Justification for the Use of Statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin, Measuring Effective Reductions in Cholesterol Using Rosuvastatin Therapy II, Treating to New Targets-Incremental Decrease in End Points Through Aggressive Lipid Lowering and Collaborative Atorvastatin Diabetes Study, demonstrating that apoB better identifies residual risk than non-HDL-C will be reviewed.


CONCLUSIONS
Comparing markers such as non-HDL-C and apoB for the accuracy with which they identify risk during a trial is essential but not sufficient. It is also necessary to compare markers for how well they identify residual risk, and, in this regard, apoB clearly outperforms non-HDL-C.
Sniderman
Allan
A
Mike Rosenbloom Laboratory for Cardiovascular Research, McGill University Health Centre, Royal Victoria Hospital, Montreal, Quebec, Canada. allansniderman@hotmail.com
D000924:Anticholesteremic Agents / Q000627:therapeutic use; D001055:Apolipoproteins B / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000188:drug therapy*; D008078:Cholesterol, LDL / Q000378:metabolism; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male
D000924:Anticholesteremic Agents; D001055:Apolipoproteins B; D015415:Biomarkers; D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents