Spotlight Series: Mixed Dyslipidemia


Back to topics


Beyond LDL-C: The Value of Measuring Other Atherogenic Lipoproteins & Markers of Atherogenic Risk


Summary


This CME presentation reviews the available measurement techniques to assess the risk associated with LDL cholesterol and LDL particles that can be obtained from the traditional lipid profile (calculated LDL-cholesterol, triglycerides, non-HDL-cholesterol), apolipoprotein B and what has been termed "advanced lipoprotein testing". LDL size and density can be measured by at least three available techniques, but generally those measurements do not provide incremental prognostic information on top of non-HDL-cholesterol. In most studies of persons with elevated triglyceride levels, apoB and non-HDL-cholesterol outperform LDL-C as a predictor of future events and as an index of residual risk, with apo B being the best predictor of all the lipid parameters. LDL particle number can be measured more accurately by measuring apo B or by nuclear magnetic resonance than it can by the standard lipid profile. This presentation aims to summarize the available evidence regarding lipid measurement and risk prediction.


Learning Objectives


After completing this activity, participants should be able to:


  • State the current recommendations of the NCEP ATP III guidelines for LDL measurement.
  • Identify characteristics of Pattern B or the “atherogenic lipoprotein phenotype”.
  • Explain the rationale for measuring other lipoproteins and markers of atherogenic risk in addition to LDL-C.
  • Recognize the residual risk of major cardiovascular disease for patients treated with intensive, high-dose statins.
  • Use the consensus statement from the American Diabetes Association (ADA) and American College of Cardiology (ACC) on lipoprotein management in patients with cardiometabolic risk to set treatment targets for LDL-C, non-HDL-C and ApoB for high-risk and highest-risk patients.

This topic is CME/CE certified by the American Heart Association for physicians, physician's assistants, nurses and pharmacists.


If interested in requesting this free presentation, please click on the Event Request tab.