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Comparison of conventional lipoprotein tests and apolipoproteins in the prediction of cardiovascular disease: Data from UK Biobank

Circulation Aug 21, 2019

Welsh C, Celis-Morales CA, Brown R, et al. - Researchers focused on the utility of lipids other than total cholesterol and high-density lipoprotein cholesterol (HDL-C) in cardiovascular disease (CVD) risk prediction. They performed primary analysis among 346,686 participants from UK Biobank without baseline CVD and not receiving statins, with relevant lipid measurements. Using Cox models adjusting for classical risk factors, comparisons were performed for the links of nonfasting lipid measurements (total cholesterol, HDL-C, non–HDL-C, direct and calculated low-density lipoprotein cholesterol [LDL-C], and apolipoproteins A1 and B) with CVD. Using the C-index and net reclassification index, the predictive utility was assessed. Findings revealed the adequacy of total cholesterol and HDL-C measurements in the nonfasted state for capturing the lipid-related risk in CVD prediction, however, the addition of apolipoproteins, direct or calculated LDL-C resulted in no meaningful improvement.
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