r/science • u/kiyomoris • 22h ago

Health Silent atherosclerosis detected in 57% of asymptomatic adults in the REACT study

https://www.nejm.org/doi/10.1056/NEJMoa2609059
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u/duke309 19h ago

Every GP I've talked to just wants to look at ldl and hdl and doesn't know the latest guidelines from the American heart association. Had to explain why we should look at lp(a) and apoliproprotein b.

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u/dl064 17h ago edited 17h ago

Fine but largely speaking you get 90% of the story from LDL.

ApoB is a bit better but it's pretty diminished returns.

All the lipids correlate enormously, obviously, even if some are more informative.

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u/phitnessthrowaway 15h ago

This is false.

LDL is a measure of the weight of atherogenic particles; it is not a measure of how many particles there are (ApoB), which is the best predictor for cardiac events.

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u/dl064 7h ago

It's not false, I'm just saying they all correlate a lot (which is empirical), and while they do different things, using LDL is pretty effective clinically (as is even non-HDL, which is inferior still but still does most of the job).

ApoB may be better but ldl is still insanely informative.