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Should advanced lipoprotein testing be used in clinical practice?

Nature Clinical Practice Cardiovascular Medicine volume 3, pages 640–641 (2006)Cite this article

Lipid-lowering therapy can prevent sudden cardiac death, myocardial infarction, stroke, and coronary revascularization procedures.1 Guidelines for the diagnosis and management of dyslipidemia have focused on LDL cholesterol as the primary target for lipid-lowering therapy;1 however, many patients with cardiovascular disease do not have elevated LDL cholesterol levels.2 This could be attributable to the limitations of measuring and interpreting LDL cholesterol levels.

Lipids, such as cholesterol and triglycerides, are surrogate markers for lipoproteins. As such, abnormalities of plasma lipid concentrations (dyslipidemia) really represent dyslipoproteinemias.3 LDL cholesterol is the concentration of cholesterol carried by plasma LDL, and is a surrogate for the number of LDL particles, which is not measured routinely in clinical laboratories. Instead, LDL cholesterol is estimated using the Friedewald equation.

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Acknowledgements

JH Stein is funded by the National Center for Research Resources (RR-1617601).

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Authors and Affiliations

  1. Associate Professor of Medicine, Director of the Preventive Cardiology Program and Director of the Atherosclerosis Imaging Research Program, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    James H Stein

  2. Professor of Medicine and Family Medicine, Associate Director of the Preventive Cardiology Program and the Associate Dean for Students, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Patrick E McBride

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  1. James H Stein
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Correspondence to James H Stein.

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Competing interests

JH Stein has served as a consultant for Abbott, LipoScience, Pfizer, and Sanofi-Aventis. He has received research and/or training grants from Astra-Zeneca, Bristol-Myers Squibb, Kos, LipoScience, and Sanofi-Aventis. He has been on the Speaker's Bureaus for Kos, LipoScience, Merck, Pfizer, Sanofi-Aventis, Schering-Plough, and Takeda. PE McBride has served as a consultant for Merck. He has been on the Speaker's Bureaus for Abbott, Bristol-Myers Squibb, Kos, Merck, Pfizer, Reliant, Sankyo-Pharma, and Schering-Plough.

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Stein, J., McBride, P. Should advanced lipoprotein testing be used in clinical practice?. Nat Rev Cardiol 3, 640–641 (2006). https://doi.org/10.1038/ncpcardio0719

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