TY - JOUR

T1 - Quantifying atherogenic lipoproteins for lipid-lowering strategies

T2 - Consensus-based recommendations from EAS and EFLM

AU - Nordestgaard, Børge G

AU - Langlois, Michel R

AU - Langsted, Anne

AU - Chapman, M John

AU - Aakre, Kristin M

AU - Baum, Hannsjörg

AU - Borén, Jan

AU - Bruckert, Eric

AU - Catapano, Alberico

AU - Cobbaert, Christa

AU - Collinson, Paul

AU - Descamps, Olivier S

AU - Duff, Christopher J

AU - von Eckardstein, Arnold

AU - Hammerer-Lercher, Angelika

AU - Kamstrup, Pia R

AU - Kolovou, Genovefa

AU - Kronenberg, Florian

AU - Mora, Samia

AU - Pulkki, Kari

AU - Remaley, Alan T

AU - Rifai, Nader

AU - Ros, Emilio

AU - Stankovic, Sanja

AU - Stavljenic-Rukavina, Ana

AU - Sypniewska, Grazyna

AU - Watts, Gerald F

AU - Wiklund, Olov

AU - Laitinen, Päivi

AU - European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Joint Consensus Initiative

N1 - Copyright © 2019 Elsevier B.V. All rights reserved.

PY - 2020/2

Y1 - 2020/2

N2 - 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.

AB - 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.

U2 - 10.1016/j.atherosclerosis.2019.12.005

DO - 10.1016/j.atherosclerosis.2019.12.005

M3 - Review

C2 - 31928713

VL - 294

SP - 46

EP - 61

JO - Atherosclerosis

JF - Atherosclerosis

SN - 0021-9150

ER -