Traditional and Emerging Lipid Markers for Cardiovascular Risk Assessment in Young vs Older Adults

Are emerging lipid biomarkers—apolipoprotein B (apoB) and lipoprotein(a) (Lp[a])—associated with improved atherosclerotic cardiovascular disease (ASCVD) risk assessment beyond Predicting Risk of Cardiovascular Disease Events (PREVENT) equations?In this cohort study of 10 519 adults from 3 large US prospective studies, apoB was associated with ASCVD events even after adjustment for traditional lipid markers, especially in adults aged 18 to 39 years. Adding apoB, but not Lp(a), to the estimated PREVENT risk was associated with improved 10- and 30-year net risk reclassification, particularly among younger adults.These findings suggest that adding apoB to PREVENT-estimated risks may improve risk reclassification, particularly in younger adults, although the clinical importance remains uncertain.

Corresponding Author: Yiyi Zhang, PhD, Division of General Medicine, Columbia University Irving Medical Center, 622 W 168th St, PH9-103J, New York, NY 10032 (yz3160@cumc.columbia.edu).

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