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15 June 1994 | Volume 120 Issue 12 | Pages 1012-1025
Purpose: To review current knowledge of apolipoprotein quantitation used in the clinical management of persons with or at risk for the development of premature coronary artery disease.
Data Sources: The English-language literature was analyzed using MEDLINE (1975 to 1993) with key words "apolipoproteins," "quantitation," and "coronary artery disease." Article bibliographies were also reviewed to obtain additional references.
Study Selection: Published, peer-reviewed retrospective and prospective studies relevant to the association of plasma apolipoprotein levels with coronary artery disease in humans.
Data Synthesis: Most studies concerned apolipoprotein A-I (apo A-I), apolipoprotein B (apo B), and lipoprotein(a) (Lp[a]). In retrospective cross-sectional studies, apo A-I levels were not substantially more predictive of coronary artery disease than were high-density lipoprotein (HDL) cholesterol levels. In contrast, levels of apo B and Lp(a) were often more strongly associated with coronary artery disease than were traditional lipid measurements. In studies of the relation between apolipoprotein levels in children and premature coronary artery disease in their parents, Lp(a) levels, but not apo A-I and apo B levels, were consistently predictive of familial coronary artery disease. Prospective studies have yielded variable results for all three apolipoproteins. Low apo A-I levels were consistently associated with coronary artery disease in six prospective studies but were not more predictive than HDL levels. Apolipoprotein B levels were strongly associated with coronary artery disease in four of five prospective studies but were more predictive of coronary artery disease than were total cholesterol levels in only two of the four studies. Lipoprotein(a) levels were strongly associated with coronary artery disease in five of seven prospective studies but were not associated in two of the four largest studies.
Conclusions: Too few large prospective studies of apolipoprotein quantitation using validated assay methods, both in general unselected populations and in subgroups of persons with premature coronary artery disease or family histories of premature coronary artery disease, are available to make definitive recommendations concerning clinical utility. The data do not support use of apolipoprotein quantitation as a screening tool to predict coronary artery disease risk in the general population. However, the data suggest that quantitation of apo B and Lp(a) may be indicated in subgroups of persons with premature coronary artery disease or with family histories of premature coronary artery disease. In these persons, an increased apo B or Lp(a) level or both could be a clinical indication for more aggressive treatment of low-density lipoprotein cholesterol.
Author and Article Information
From the Molecular Disease Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
REVIEW
Quantitation of Plasma Apolipoproteins in the Primary and Secondary Prevention of Coronary Artery Disease
Requests for Reprints: Daniel Rader, MD, Institute for Human Gene Therapy, University of Pennsylvania Medical Center, 601 Maloney, 3400 Spruce Street, Philadelphia, PA 19104.
Acknowledgments: The authors thank Loan Kusterbeck and Donna James for secretarial assistance.
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|
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|
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|
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|
|
|
|
|
|
References Circulation, December 17, 2002; 106(25): 3373 - 3421. [Full Text]
|
|
|
|
 |
|
 V. Raos and B. J. Strujic Dyslipoproteinemia and Coronary Disease Angiology, September 1, 2002; 53(5): 557 - 562. [Abstract] [PDF]
|
|
|
|
 |
|
 M. Peltier, M. C. Iannetta Peltier, M. E. Sarano, J.-P. M. Lesbre, J.-L. Colas, and C. M. Tribouilloy Elevated Serum Lipoprotein(a) Level Is an Independent Marker of Severity of Thoracic Aortic Atherosclerosis* Chest, May 1, 2002; 121(5): 1589 - 1594. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. M Ordovas, D. Corella, L A. Cupples, S. Demissie, A. Kelleher, O. Coltell, P. W. Wilson, E. J Schaefer, and K. Tucker Polyunsaturated fatty acids modulate the effects of the APOA1 G-A polymorphism on HDL-cholesterol concentrations in a sex-specific manner: the Framingham Study Am. J. Clinical Nutrition, January 1, 2002; 75(1): 38 - 46. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. R. Sharrett, C. M. Ballantyne, S. A. Coady, G. Heiss, P. D. Sorlie, D. Catellier, and W. Patsch Coronary Heart Disease Prediction From Lipoprotein Cholesterol Levels, Triglycerides, Lipoprotein(a), Apolipoproteins A-I and B, and HDL Density Subfractions: The Atherosclerosis Risk in Communities (ARIC) Study Circulation, September 4, 2001; 104(10): 1108 - 1113. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
 |
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
 A. Oberman Hypertriglyceridemia and Coronary Heart Disease J. Clin. Endocrinol. Metab., June 1, 2000; 85(6): 2098 - 2105. [Full Text]
|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
 J S Skinner, M Farrer, C J Albers, H A W Neil, and P C Adams High apolipoprotein AI concentrations are associated with lower mortality and myocardial infarction five years after coronary artery bypass graft surgery Heart, May 1, 1999; 81(5): 488 - 494. [Abstract] [Full Text]
|
|
|
|
|
|
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|
|
|
|
 |
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
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|
|
|
|
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|
|
|
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|
|
|
|
|
|
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|
|
|
|
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