This episode explores the clinical utility of ApoB testing in cardiovascular risk assessment, contrasting it with traditional LDL cholesterol measurements. The discussion centers on the concordance and discordance between ApoB and LDL cholesterol levels, highlighting that while they correlate in approximately 60-70% of the population, significant discrepancies can exist. More significantly, the conversation delves into the implications of this discordance, particularly in identifying residual risk in patients undergoing lipid-lowering therapy where LDL cholesterol may reach target levels, but ApoB remains elevated, indicating persistent risk. For instance, the podcast cites studies using data from the IMPROVE-IT and FOURIER trials to demonstrate this phenomenon. Against this backdrop, the speakers emphasize that while discordance analysis methods vary, ApoB proves a superior predictor of residual risk compared to LDL cholesterol, regardless of the formula used for LDL calculation. In conclusion, the podcast advocates for considering ApoB measurements, especially in cases of discordance, to refine risk assessment and potentially improve treatment strategies, although further research is needed to fully understand the clinical implications of treating ApoB to specific target levels.
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