LDL has been widely recognized as the major atherogenic
lipoprotein and designated as the primary target for prevention of
coronary heart disease (CHD); however, there is growing evidence that other
triglyceride-rich
lipoproteins, such as
very low-density lipoprotein (VLDL) and
intermediate density lipoprotein (IDL) carry atherogenic potential as well. This led to the designation of non-
HDL cholesterol (HDL-C) (
LDL + IDL + VLDL) as a secondary target of treatment for hyperlipidaemia. As each one of
LDL, IDL and VLDL particles carries only one
apolipoprotein B-100 (ApoB-100) molecule, the total
ApoB value represents the total number of potentially atherogenic
lipoproteins, whereas non-HDL-C provides the
cholesterol content of these same
lipoproteins. Recent data from epidemiological, observational and interventional studies suggest that non-HDL-C,
apolipoproteins ApoA1 and
ApoB may improve CHD risk assessment by identifying more high-risk individuals than the usual
lipid profile alone. However, the targets for the optimal treatment of dyslipidaemia remain a subject of considerable debate. Further studies are needed to determine whether
ApoB and ApoA1 are superior to conventional
lipid parameters as predictors of
cardiovascular disease or therapeutic targets of hyperlipidaemias. In this review, we summarize the current opinions on the use of ApoA1 and
ApoB values as estimates of cardiovascular risk or as treatment goals in patients undergoing treatment for hyperlipidaemia.