[Apolipoproteins are new and better risk indicators of myocardial infarction]

Abstract

In order to make an appropriate evaluation of cardiac risk related to lipids for a given individual, measurements of the "bad" LDL and the "good" HDL should be performed. Often a value of total cholesterol can be misleading. Cholesterol and triglycerides in the blood are bound to and transported by apolipoproteins (apo). ApoB only occurs in the atherogenic lipoproteins, mainly in LDL, whereas apoA-I is bound only to HDL. We review prospective epidemiological trials and clinical trials in which statins have been used to reduce cardiac risk. The results indicate that apoB, apoA-I, and especially the balance of apoB/apoA-I, are more closely related to cardiac risk and to clinical outcome than LDL or HDL. Methodological advantages speak in favour of measuring apoB and apoA-I in clinical practice.