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In this recent paper 30 international researchers from 10 countries argue for the atherogenic lipoprotein particle paradigm: that the total number of atherogenic particles is a more important determinant of the risk of cardiovascular disease than any of the conventional lipid measures
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Barter PJ, Ballantyne CM, Carmena R, et al. ApoB versus cholesterol in estimating cardiovascular risk and in guiding therapy: report of the thirtyperson/ten-country panel. J Intern Med 2006; 259:247-258. In this recent paper 30 international researchers from 10 countries argue for the atherogenic lipoprotein particle paradigm: that the total number of atherogenic particles is a more important determinant of the risk of cardiovascular disease than any of the conventional lipid measures.
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Chan DC, Watts GF. Apolipoproteins as markers and managers of coronary risk. Q J Med 2006; 99:277-287. In this recent Australian review the authors advocate that measurements of apolipoproteins should be routinely added to the routine lipid profile and that apolipoproteins also could replace the standard 'lipid profile' as a target for therapy in at-risk patients.
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Walldius G, Jungner I. The apoB/apoA-I ratio: a strong, new risk factor for cardiovascular disease and a target for lipid-lowering therapy: a review of the evidence. J Intern Med 2006; 259:493-519. In this review the authors present evidence from recent Swedish and international studies indicating that apoB and apoA-I, especially the apoB/apoA-I ratio, are the best lipid-related summary index of cardiovascular risk. This ratio is also a strong predictor of outcome in lipid-lowering trials. The authors recommend that new guidelines should include apoB and apoA-I.
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Walldius G, Jungner I. The apoB/apoA-I ratio: a strong, new risk factor for cardiovascular disease and a target for lipid-lowering therapy: a review of the evidence. J Intern Med 2006; 259:493-519. In this review the authors present evidence from recent Swedish and international studies indicating that apoB and apoA-I, especially the apoB/apoA-I ratio, are the best lipid-related summary index of cardiovascular risk. This ratio is also a strong predictor of outcome in lipid-lowering trials. The authors recommend that new guidelines should include apoB and apoA-I.
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Sniderman AD, Marcovina SM. Apolipoprotein AI and B. Clin Lab Med 2006; 26:733-750. This recent Canadian-American overview is highly focused on apoB as a more powerful risk factor than the conventional cholesterol indices. More data are required to decide if the risk for CVD is best measured as HDL cholesterol or ApoA-I. At a technical level, however, apoA-I is clearly superior; its measurement is standardized, automated, and inexpensive.
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Sniderman AD, Marcovina SM. Apolipoprotein AI and B. Clin Lab Med 2006; 26:733-750. This recent Canadian-American overview is highly focused on apoB as a more powerful risk factor than the conventional cholesterol indices. More data are required to decide if the risk for CVD is best measured as HDL cholesterol or ApoA-I. At a technical level, however, apoA-I is clearly superior; its measurement is standardized, automated, and inexpensive.
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Sacks FM. The apolipoprotein story. Atherosclerosis 2006; 7 (Suppl):23-27. This recent paper, by an American author, continues the debate and describes the clear advantages of using apoB as a predictor of coronary artery disease and how recent studies show its predictive superiority over LDL and non-HDL cholesterol.
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Sacks FM. The apolipoprotein story. Atherosclerosis 2006; 7 (Suppl):23-27. This recent paper, by an American author, continues the debate and describes the clear advantages of using apoB as a predictor of coronary artery disease and how recent studies show its predictive superiority over LDL and non-HDL cholesterol.
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Packard CJ, Rader DJ, editors. Lipids and atherosclerosis. Advances in translational medical science. Abingdon, UK: Taylor & Francis Group; 2006. An excellent comprehensive overview of lipoprotein metabolism, which entails a wide variety of topics spanning several different disciplines and highlighting how advances in our basic understanding of lipoprotein metabolism can be translated to the development of new therapeutic agents.
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Barter PJ, Rye K-A. The rationale for using apoA-I as a clinical marker of cardiovascular risk. J Intern Med 2006; 259:447-454. This recent paper describes the key role of apoA-I as the main apolipoprotein of HDLs.
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Marcovina S, Packard CJ. Measurement and meaning of apolipoprotein AI and apolipoprotein B plasma levels. J Intern Med 2006; 259:437-446. A recent paper describing how measurement of apolipoproteins has been internationally standardized and how, in contrast, the accuracy and comparability of the HDL and LDL cholesterol measurements are more problematic. Unlike apoA-I and apoB, there is no common reference material for these conventional lipid measurements. Also 'direct' HDL measurements have inherent method-dependent inaccuracies.
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Charlton-Menys V, Durrington P. Apolipoproteins A-I and B as therapeutic targets. J Intern Med 2006; 259:462-472. This paper emphasizes that raising low levels of HDL, probably best measured as apoA-I, may prove to be an important aim of treatment. The apoB/apoA-I ratio could easily replace the total cholesterol/HDL cholesterol ratio used in CVD risk prediction. Automated apoA-I immunoassay is a much better alternative than the HDL cholesterol measurements used today in virtually all clinical laboratories. ApoB would be a superior target to optimize statin therapy.
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Charlton-Menys V, Durrington P. Apolipoproteins A-I and B as therapeutic targets. J Intern Med 2006; 259:462-472. This paper emphasizes that raising low levels of HDL, probably best measured as apoA-I, may prove to be an important aim of treatment. The apoB/apoA-I ratio could easily replace the total cholesterol/HDL cholesterol ratio used in CVD risk prediction. Automated apoA-I immunoassay is a much better alternative than the HDL cholesterol measurements used today in virtually all clinical laboratories. ApoB would be a superior target to optimize statin therapy.
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Stein EA. Analytical issues and their clinical impact: lipoproteins. NACB Symposium; Baltimore, USA; 21 October 2006. Version 091906. http://www.aacc.org/AACC/members/nacb/LMPG/OnLineGuide/DraftGuidelines/ Emerg_Risk_Factors/default.htm. [Accessed 13 April 2007] Based on CAP survey data the author demonstrates that apoB measurements are well 'standardized' and reproducible between labs, that apoB measurements are widely available and more 'reliable' in 2006 than either 'direct' LDL cholesterol or 'homogeneous' HDL cholesterol, that apoA-I is now readily analyzed by most large labs and that apoA-I performance is still better than for 'homogeneous' HDL cholesterol which is now widely used.
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