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Quantifying atherogenic lipoproteins for lipid-lowering strategies: Consensus-based recommendations from EAS and EFLM.

Nordestgaard, BG; Langlois, MR; Langsted, A; Chapman, MJ; Aakre, KM; Baum, H; Borén, J; Bruckert, E; Catapano, A; Cobbaert, C; et al. Nordestgaard, BG; Langlois, MR; Langsted, A; Chapman, MJ; Aakre, KM; Baum, H; Borén, J; Bruckert, E; Catapano, A; Cobbaert, C; Collinson, P; Descamps, OS; Duff, CJ; von Eckardstein, A; Hammerer-Lercher, A; Kamstrup, PR; Kolovou, G; Kronenberg, F; Mora, S; Pulkki, K; Remaley, AT; Rifai, N; Ros, E; Stankovic, S; Stavljenic-Rukavina, A; Sypniewska, G; Watts, GF; Wiklund, O; Laitinen, P; European Atherosclerosis Society (EAS) and the European Federati (2020) Quantifying atherogenic lipoproteins for lipid-lowering strategies: Consensus-based recommendations from EAS and EFLM. Atherosclerosis, 294. pp. 46-61. ISSN 1879-1484 https://doi.org/10.1016/j.atherosclerosis.2019.12.005
SGUL Authors: Collinson, Paul

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Abstract

The joint consensus panel of the European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) recently addressed present and future challenges in the laboratory diagnostics of atherogenic lipoproteins. Total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, and calculated non-HDL cholesterol (=total - HDL cholesterol) constitute the primary lipid panel for estimating risk of atherosclerotic cardiovascular disease (ASCVD) and can be measured in the nonfasting state. LDL cholesterol is the primary target of lipid-lowering therapies. For on-treatment follow-up, LDL cholesterol shall be measured or calculated by the same method to attenuate errors in treatment decisions due to marked between-method variations. Lipoprotein(a)-cholesterol is part of measured or calculated LDL cholesterol and should be estimated at least once in all patients at risk of ASCVD, especially in those whose LDL cholesterol decline poorly upon statin treatment. Residual risk of ASCVD even under optimal LDL-lowering treatment should be also assessed by non-HDL cholesterol or apolipoprotein B, especially in patients with mild-to-moderate hypertriglyceridemia (2-10 mmol/L). Non-HDL cholesterol includes the assessment of remnant lipoprotein cholesterol and shall be reported in all standard lipid panels. Additional apolipoprotein B measurement can detect elevated LDL particle numbers often unidentified on the basis of LDL cholesterol alone. Reference intervals of lipids, lipoproteins, and apolipoproteins are reported for European men and women aged 20-100 years. However, laboratories shall flag abnormal lipid values with reference to therapeutic decision thresholds.

Item Type: Article
Additional Information: Co-published in Clinical Chemistry and Laboratory Medicine. For an open access version, please see http://openaccess.sgul.ac.uk/111671/
Keywords: Apolipoprotein B, Atherosclerotic cardiovascular disease, LDL cholesterol, Lipoprotein(a), Remnant cholesterol, non-HDL cholesterol, European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Joint Consensus Initiative, 1103 Clinical Sciences, 1102 Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Atherosclerosis
ISSN: 1879-1484
Language: eng
Dates:
DateEvent
February 2020Published
9 January 2020Published Online
12 December 2019Accepted
Publisher License: Publisher's own licence
PubMed ID: 31928713
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/111699
Publisher's version: https://doi.org/10.1016/j.atherosclerosis.2019.12.005

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