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Is the Commitment to LDL-C Eternal? Cover
Open Access
|Sep 2026

References

  1. Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. The Expert Panel. Arch Intern Med. 1988 Jan;148(1):36-69. PMID: 3422148.
  2. Writing Committee Memebers, Blumenthal RS, Morris PB, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026 Mar;153(17). doi: 10.1161/CIR.0000000000001423
  3. Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020 Jan 1;41(1):111-188. doi: 10.1093/eurheartj/ehz455
  4. Contois JH, Langlois MR, Cobbaert C, Sniderman AD. Standardization of Apolipoprotein B, LDL-Cholesterol, and Non-HDL-Cholesterol. J Am Heart Assoc. 2023 Aug;12(15):e030405. doi: 10.1161/JAHA.123.030405
  5. Mach F, Koskinas KC, Roeters van Lennep JE, et al. 2025 Focused Update of the 2019 ESC/EAS Guidelines for the management of dyslipidaemias. Eur Heart J. 2025 Nov 7;46(42):4359-4378. doi: 10.1093/eurheartj/ehaf190
  6. Avogaro P, Bon GB, Cazzolato G, Quinci GB. Are apolipoproteins better discriminators than lipids for atherosclerosis? Lancet. 1979 Apr 28;1(8122):901-903. doi: 10.1016/s0140-6736(79)91375-8
  7. Sniderman A, Shapiro S, Marpole D, Skinner B, Teng B, Kwiterovich PO Jr.. Association of coronary atherosclerosis with hyperapobetalipoproteinemia [increased protein but normal cholesterol levels in human plasma low density (beta) lipoproteins]. Proc Natl Acad Sci USA. 1980 Jan;77(1):604-608. doi: 10.1073/pnas.77.1.604
  8. Avogaro P, Bon GB, Cazzolato G. Need for new classification of lipoprotein derangements in human atherosclerosis. Lancet. 1981 Jun 6;1(8232):1257. doi: 10.1016/s0140-6736(81)92418-1
  9. Alaupovic P. Apoliproproteins and lipoproteins. Atherosclerosis. 1971 Mar-Apr;13(2):141-146. doi: 10.1016/0021-9150(71)90018-9
  10. Walldius G, Jungner I, Holme I, Aastveit AH, Kolar W, Steiner E. High apolipoprotein B, low apolipoprotein A-I, and improvement in the prediction of fatal myocardial infarction (AMORIS study): a prospective study. Lancet. 2001 Dec 15;358(9298):2026-2033. doi: 10.1016/S0140-6736(01)07098-2
  11. Walldius G. High apoB/apoA-1 ratio is a strong risk predictor of major adverse cardio- and cerebrovascular events part 1: a review basis for updating guidelines. Expert Rev Cardiovasc Ther. 2025 Sep;23(9):521-545. doi: 10.1080/14779072.2025.2543537
  12. Walldius G. High apoB/apoA-1 ratio is a strong risk predictor of major adverse cardio- and cerebrovascular events part 2: a review basis for updating guidelines. Expert Rev Cardiovasc Ther. 2025;23(9):547-566. doi: 10.1080/14779072.2025.2543535
  13. Barter PJ, Ballantyne CM, Carmena R, et al. Apo B versus cholesterol in estimating cardiovascular risk and in guiding therapy: report of the thirty-person/ten-country panel. J Intern Med. 2006 Mar;259(3):247-258. doi: 10.1111/j.1365-2796.2006.01616.x
  14. Veerkamp MJ, de Graaf J, Hendriks JC, Demacker PN, Stalenhoef AF. Nomogram to diagnose familial combined hyperlipidemia on the basis of results of a 5-year follow-up study. Circulation. 2004 Jun 22;109(24):2980-2985. doi: 10.1161/01.CIR.0000130646.93255.86
  15. Brouwers M, Klop B, Ribalta J, Castro Cabezas M. Familial Combined Hyperlipidemia: Myth or Reality? Curr Atheroscler Rep. 2025 Apr 1;27(1):45. doi: 10.1007/s11883-025-01289-9.
  16. Bello-Chavolla OY, Kuri-Garcia A, Rios-Rios M, et al. Familial Combined Hyperlipidemia: Current Knowledge, Perspectives, and Controversies. Rev Invest Clin. 2018;70(5):224-236. doi: 10.24875/RIC.18002575
  17. Sniderman AD, St-Pierre AC, Cantin B, Dagenais GR, Despres JP, Lamarche B. Concordance/discordance between plasma apolipoprotein B levels and the cholesterol indexes of atherosclerotic risk. Am J Cardiol. 2003 May 15;91(10):1173-1177. doi: 10.1016/s0002-9149(03)00262-5
  18. Johannesen CDL, Mortensen MB, Nordestgaard BG, Langsted A. Discordance analyses comparing LDL cholesterol, Non-HDL cholesterol, and apolipoprotein B for cardiovascular risk estimation. Atherosclerosis. 2025 Apr;403:119139. doi: 10.1016/j.atherosclerosis.2025.119139
  19. Sehayek D, Cole J, Bjornson E, et al. ApoB, LDL-C, and non-HDL-C as markers of cardiovascular risk. J Clin Lipidol. 2025 Jul-Aug;19(4):844-859. doi: 10.1016/j.jacl.2025.05.024
  20. Teng B, Sniderman AD, Soutar AK, Thompson GR. Metabolic basis of hyperapobetalipoproteinemia. Turnover of apolipoprotein B in low density lipoprotein and its precursors and subfractions compared with normal and familial hypercholesterolemia. J Clin Invest. 1986 Mar;77(3):663-672. doi: 10.1172/JCI112360
  21. Vega GL, Beltz WF, Grundy SM. Low density lipoprotein metabolism in hypertriglyceridemic and normolipidemic patients with coronary heart disease. J Lipid Res. 1985 Jan;26(1):115-126. PMID: 3973508.
  22. Goldstein JL, Schrott HG, Hazzard WR, Bierman EL, Motulsky AG. Hyperlipidemia in coronary heart disease. II. Genetic analysis of lipid levels in 176 families and delineation of a new inherited disorder, combined hyperlipidemia. J Clin Invest. 1973 Jul;52(7):1544-1568. doi: 10.1172/JCI107332
  23. Sniderman AD, Castro Cabezas M, Ribalta J, et al. A proposal to redefine familial combined hyperlipidaemia -- third workshop on FCHL held in Barcelona from 3 to 5 May 2001, during the scientific sessions of the European Society for Clinical Investigation. Eur J Clin Invest. 2002 Feb;32(2):71-73. doi: 10.1046/j.1365-2362.2002.00941.x
  24. American Academy of Pediatrics. Committee on Nutrition. Hypoallergenic infant formulas. Pediatrics. 2000 Aug;106(2 Pt 1):346-349. PMID: 10920165.
  25. Greer FR, Sicherer SH, Burks AW, American Academy of Pediatrics Committee on N, American Academy of Pediatrics Section on A, Immunology. Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics. 2008 Jan;121(1):183-191. doi: 10.1542/peds.2007-3022
  26. Rossouw JE, Anderson GL, Prentice RL, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women’s Health Initiative randomized controlled trial. JAMA. 2002 Jul 17;288(3):321-333. doi: 10.1001/jama.288.3.321
  27. Kritchevsky D. History of recommendations to the public about dietary fat. J Nutr. 1998 Feb;128(2 Suppl):449S-452S. doi: 10.1093/jn/128.2.449S
  28. Sniderman AD. Clinical trials, consensus conferences, and clinical practice. Lancet. 1999 Jul 24;354(9175):327-330. doi: 10.1016/S0140-6736(98)11185-6
  29. Sniderman AD, Furberg CD. Pluralism of viewpoints as the antidote to intellectual conflict of interest in guidelines. J Clin Epidemiol. 2012 Jul;65(7):705-707.
  30. Sniderman AD, D’Agostino, RB Sr., Pencina MJ. The Role of Physicians in the Era of Predictive Analytics. JAMA. 2015;314(1):25-26. doi: 10.1016/j.jclinepi.2012.01.009
  31. Sniderman A, Couture P, de Graaf J. Diagnosis and treatment of apolipoprotein B dyslipoproteinemias. Nat Rev Endocrinol. 2010 Jun;6(6):335-346. doi: 10.1038/nrendo.2010.50
  32. Sayed A, Peterson ED, Virani SS, Sniderman AD, Navar AM. Individual Variation in the Distribution of Apolipoprotein B Levels Across the Spectrum of LDL-C or Non-HDL-C Levels. JAMA Cardiol. 2024 Aug 1;9(8):741-747. doi: 10.1001/jamacardio.2024.1310
  33. Kohli-Lynch C, Thanassoulis G, Pencina M, et al. The Causal-Benefit Model to Prevent Cardiovascular Events. JACC Adv. 2024 Jan 22;3(3):100825. doi: 10.1016/j.jacadv.2023.100825
  34. Sniderman AD, Dufresne L, Pencina KM, Bilgic S, Thanassoulis G, Pencina MJ. Discordance among apoB, non-high-density lipoprotein cholesterol, and triglycerides: implications for cardiovascular prevention. Eur Heart J. 2024 Jul 12;45(27):2410-2418. doi: 10.1093/eurheartj/ehae258
  35. Johannesen CDL, Langsted A, Nordestgaard BG, Mortensen MB. Excess Apolipoprotein B and Cardiovascular Risk in Women and Men. J Am Coll Cardiol. 2024 Jun 11;83(23):2262-2273. doi: 10.1016/j.jacc.2024.03.423
  36. Lyu L, Kao C, Su J, et al. Association of apolipoprotein B and excess apolipoprotein B with cardiovascular risk in type 2 diabetes: a prospective cohort study of the UK Biobank. Lipids Health Dis. 2026 Jan 15;25(1):55. doi: 10.1186/s12944-025-02852-8
  37. Briers PJ, Langlois MR. Concordance of apolipoprotein B concentration with the Friedewald, Martin-Hopkins, and Sampson formulas for calculating LDL cholesterol. Biochem Med (Zagreb). 2022 Feb 15;32(1):010704. doi: 10.11613/BM.2022.010704
  38. Pan W, Lu X, Zhou Z, et al. Excess apolipoprotein B predicts long-term survival in statin-treated CAD irrespective of achieved LDL-C levels: a pooled cohort analysis. Lipids Health Dis. 2026 Mar 24;25(1):124. doi: 10.1186/s12944-026-02928-z
  39. Giannakopoulou SP, Chrysohoou C, Antonopoulou S, et al. Association of apolipoprotein B, excess apolipoprotein B and apoB/apoA1 ratio with 20-year atherosclerotic cardiovascular disease risk: the ATTICA study (2002-2022). Clin Res Cardiol. 2026 Feb;115(2):335-346. doi: 10.1007/s00392-025-02767-5
  40. Luebbe S, Sniderman AD, Moran AE, Wilkins JT, Kohli-Lynch CN. Cost-Effectiveness of ApoB, Non-HDL-C, and LDL-C Goals for Primary Prevention Lipid-Lowering Therapy. JAMA. 2026 May 5;335(17):1507-1514. doi: 10.1001/jama.2026.2986
DOI: https://doi.org/10.14797/mdcvj.1845 | Journal eISSN: 1947-6108
Language: English
Page range: 15 - 21
Submitted on: Apr 13, 2026
Accepted on: May 12, 2026
Published on: Sep 15, 2026
Published by: Houston Methodist DeBakey Heart & Vascular Center
In partnership with: Paradigm Publishing Services
Keywords:

© 2026 Allan D. Sniderman, published by Houston Methodist DeBakey Heart & Vascular Center
This work is licensed under the Creative Commons Attribution-NonCommercial 4.0 License.