Measurement of apolipoprotein B-containing lipoproteins for routine clinical laboratory use in cardiovascular disease.

Although research studies, using complex methods, have shown apolipoprotein B level to be a better marker for coronary artery disease than cholesterol level, it is unclear whether apolipoprotein B level can perform as well when measured by automated clinical laboratory kit methods. The purpose of this study was to determine whether apolipoprotein B level assayed by a kit method is a better marker for coronary artery disease than low-density lipoprotein and total cholesterol levels in patients presenting for angiography. The subjects were two groups of male patients, 44 to 70 years old: 139 with disease and 41 without. Apolipoprotein B level differentiated more than 20-fold better than total or low-density lipoprotein cholesterol levels between the medians of the two groups and showed better diagnostic sensitivity and better diagnostic specificity than total and low-density lipoprotein cholesterol levels. Triglyceride levels were highly significant but showed poorer diagnostic sensitivity than apolipoprotein B level. We conclude that apolipoprotein B level is a more effective marker for coronary artery disease than low-density lipoprotein or total cholesterol levels.