Apolipoprotein B blood tests outperformed LDL and non-HDL cholesterol tests in guiding treatment, and could prevent heart attacks and strokes, a recent Northwestern Medicine study found.
The study, published April 8 in JAMA, used a computer simulation model to evaluate the cost-effectiveness of LDL-C, non-HDL-C or apoB blood tests. A cohort of 250,000 statin-eligible and atherosclerotic cardiovascular disease-free adults was constructed from 2005 to 2016 National Health and Nutrition Examination Survey participants. The simulated patients were screened and received statin therapy based on the 2018 guidelines.
“We found that apoB testing to intensify cholesterol-lowering medication would prevent more heart attacks and strokes than current practice, and that these health benefits were achieved at a cost that represents good value for U.S. healthcare payers,” study lead author Ciaran Kohli-Lynch, PhD, assistant professor of preventive medicine in the division of epidemiology, said in an April 20 system news release. “Research strongly shows that apolipoprotein B (apoB) is better at identifying who is at risk, because it counts the total number of harmful particles in the blood.”
ApoB is not widely used in routine care, partly due to cost and convenience, as the test requires an additional blood test besides the standard cholesterol panel.
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