By Mark Waghorn
A blood test has been developed that more accurately predicts apparently healthy patients at high risk of cardiovascular disease.
It detects a protein called ApoB rather than cholesterol – and could save thousands of lives.
Raised levels are an early sign of the world’s number one killer, but the technique is rarely used – because it is more expensive, say scientists.
Principal investigator Dr. Jeffrey Anderson, of Intermountain Health, Salt Lake City, said: “Testing for ApoB doesn’t tell you how much cholesterol a patient has, but instead it measures the number of particles that carry it.”
In the UK, over 40s who are overweight are routinely offered blood tests to check their levels of low-density lipoprotein (LDL-C), or ‘bad’ cholesterol.
It often leads to them being offered diet plans and drugs like statins.
But the ApoB test counts the exact number of LDL-C particles, rather than the amount of cholesterol stored inside them.
Experts say thousands of lives could be saved by its widescale introduction.
The LDL-C test costs around $36 – whereas the ApoB test is more than £130.
Dr. Anderson and colleagues found it helps identify patients who may still be at increased risk for a heart attack or stroke – despite having normal LDL cholesterol levels.
He said: “While it’s still not a commonly ordered test, we found that it is both being used more often, and it could lead to a more accurate way to test for lipoprotein-related risk than how we do it now.
“For example, some people have normal LDL cholesterol levels but still have a large number of particles due to an abundance of small, dense LDL particles.”
An increasing number of studies indicate that particle numbers beat cholesterol levels as risk predictors of disease.
The U.S. team examined all patients’ electronic health records from 2010 to February 2022. They found ApoB testing more than quadrupled over the period.
Dr. Anderson said ApoB is better at evaluating risk, especially for patients with normal LDL cholesterol levels, including those with metabolic syndrome, such as diabetes or prediabetes.
He added: “Data suggest that these particle numbers increase risk to a greater extent than just cholesterol levels alone.
“ApoB could help us identify a population of patients with normal or even low LDL numbers but who are at higher risk and should be more aggressively treated.”
But Dr. Anderson doesn’t expect ApoB to eclipse standard cholesterol testing anytime soon.
It is more expensive, and it’s not yet ingrained in the healthcare system in nearly as firmly a way.
But it should increasingly be considered a valuable tool for clinicians to refine cardiovascular risk, especially in these specific patient groups, he said.
Most of the time, scores for the tests are roughly aligned.
But research in the UK has found in about two percent of cases – equivalent to thousands of patients – only the ApoB test picks up a cause for concern.
About two in five people in the UK have high cholesterol, and in the U.S. nearly one in three adults are suffering from the condition.
Cardiovascular disease claims around 18 million lives globally every year.
The findings were presented at an American College of Cardiology meeting in New Orleans.
Produced in association with SWNS Talker
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