Use of certain lipid measures not more effective in predicting coronary hea...(elatively less well compared with the li...),Health

Date:8/14/2007

elatively less well compared with the lipid ratios. Second, when CHD risk reclassification was evaluated, the differences in net reclassification improvement offered by the total cholesterol:HDL-C ratio vs. the apo B:apo A-I ratio were small and statistically nonsignificant in both sexes. Third, the apo B:apo A-I ratio was not significantly associated with CHD incidence in either sex when added to a model that incorporated components of the Framingham risk score, including total cholesterol:HDL-C. This observation suggests that apo B:apo A-I ratio does not provide incremental predictive utility over established CHD risk factors including traditional lipid measures, the authors write.

Given overall equal performance of various lipids ratios, other factors will be critical in guiding the choice of lipid measures that should be used for CHD risk prediction. These factors include the costs and availability of assays, educational needs for health care professionals and the public for interpreting apolipoprotein measures, the possibility of obtaining valid measurements for risk prediction in nonfasting samples or in patients receiving lipid-lowering treatment, and the availability of appropriate therapeutic cutpoints and clinical evidence of benefits accruing from lowering levels (based on randomized, controlled clinical trials). However, with regard to test performance characteristics, our data do not support the need for measuring apo B or apo A-I in clinical practice when traditional lipid measurements are obtained routinely, the researchers conclude.

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Contact: Esta Shindler 508-935-3434 JAMA and Archives Journals Source:Eurekalert

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