Potential effect of an apoprotein B-based algorithm on management of new patients with hypertriglyceridemia referred to a specialty lipid clinic.

BACKGROUND In patients with hypertriglyceridemia, non-high density lipoprotein cholesterol (nonHDL-C) is a targeted goal. However, apoprotein B100 (apoB) may be superior in predicting cardiovascular risk so we assessed the utility of an apoB-based. METHODS New patients (n = 125) who had both apoB and standard lipids measured on the same day were included and we determined the concordances of having achieved goal lipid levels based upon proposed apoB versus nonHDL-C (ATP III) targets in patients with elevated TG (>or=150 mg*dl(-1)) levels. RESULTS Although apoB was correlated with nonHDL-C (r = 0.47, p or= 150 mg*dl(-1), as specifically outlined in ATP III guidelines. In total, > 50% of all subjects would have been treated either more or less aggressively following an apoB-based therapeutic algorithm. CONCLUSIONS Our findings confirm that the majority of patients referred with hypertriglyceridemia would be managed differently by following an apoB-based treatment algorithm compared to ATP III guidelines. Although many patients would be candidates for more intense therapy, many would be treated less aggressively.