Apolipoproteins for Cardiovascular Risk Assessment

Abstract

Clinical Question: Is measurement of apolipoproteins better than traditional lipid measurements for predicting cardiovascular risk? Evidence-Based Answer: Measurement of apolipoprotein B and apolipoprotein A-I is no better than traditional lipid measurements and should not be used to predict cardiovascular risk. (Strength of Recommendation: B, based on meta-analyses with conflicting results.) Apolipoprotein B and non-high-density lipoprotein cholesterol (HDL-C) predict cardiovascular risk slightly better than low-density lipoprotein cholesterol. Elevated levels of apolipoprotein A-I predict a lower risk of cardiovascular events except stroke, but not as well as elevated HDL-C levels.