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Targets for LDL-lowering therapy

Purpose of review To compare non-HDL-cholesterol (non-HDL-C) and apolipoprotein B (apoB) as targets for LDL-lowering therapy. The conventional approach is restricted to a comparison of in-trial data. Although essential, this overlooks the issue as to which marker better identifies residual risk after any particular treatment regimen. Recent findings Data from a series of recent studies, including Justification for the Use of Statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin, Measuring Effective Reductions in Cholesterol Using Rosuvastatin Therapy II, Treating to New Targets–Incremental Decrease in End Points Through Aggressive Lipid Lowering and Collaborative Atorvastatin Diabetes Study, demonstrating that apoB better identifies residual risk than non-HDL-C will be reviewed. Summary Comparing markers such as non-HDL-C and apoB for the accuracy with which they identify risk during a trial is essential but not sufficient. It is also necessary to compare markers for how well they identify residual risk, and, in this regard, apoB clearly outperforms non-HDL-C.