Risk Factors, Risk Prediction, and the Apolipoprotein B–Apolipoprotein A-I Ratio
Authors: Michael Berkwits, Eliseo Guallar
Journal: Annals of Internal Medicine (2007)

Editorials1 May 2007Risk Factors, Risk Prediction, and the Apolipoprotein B–Apolipoprotein A-I RatioMichael Berkwits, MD, MSCE, Deputy Editor and Eliseo Guallar, MD, PhDMichael Berkwits, MD, MSCE, Deputy EditorFrom the American College of Physicians, Philadelphia, PA 19106, and Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205. and Eliseo Guallar, MD, PhDFrom the American College of Physicians, Philadelphia, PA 19106, and Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-146-9-200705010-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In this issue, van der Steeg and colleagues report the results of a nested case–control study demonstrating that the apolipoprotein B–apolipoprotein A-I (apo B–apo A-I) ratio is a risk factor for future coronary events, independent of low-density lipoprotein cholesterol level, high-density lipoprotein cholesterol level, and other traditional risk factors (1). The study also suggests that the apo B–apo A-I ratio negligibly improves overall risk prediction compared with conventional coronary risk factors and the Framingham risk score. This latter finding contradicts an emerging literature that enthusiastically endorses the apo B–apo A-I ratio as an improved measure of risk (2–5). It is ...References1. van der Steeg WA, Boekholdt SM, Stein EA, El-Harchaoui K, Stroes ES, Sandhu MS, et al. Role of the apolipoprotein B–apolipoprotein A-I ratio in cardiovascular risk assessment: a case–control analysis in the EPIC-Norfolk. Ann Intern Med. 2007;146:640-8. LinkGoogle Scholar2. 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;358:2026-33. [PMID: 11755609] CrossrefMedlineGoogle Scholar3. INTERHEART Study Investigators. 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The effect of including C-reactive protein in cardiovascular risk prediction models for women. Ann Intern Med. 2006;145:21-9. [PMID: 16818925] LinkGoogle Scholar20. Cook NR. Use and misuse of the receiver operating characteristic curve in risk prediction. Circulation. 2007;115:928-35. [PMID: 17309939] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From the American College of Physicians, Philadelphia, PA 19106, and Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205.Disclosures: None disclosed.Corresponding Author: Customer Service, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.Current Author Addresses: Dr. Berkwits: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.Dr. Guallar: Johns Hopkins University Bloomberg School of Public Health, 2024 East Monument Street, Baltimore, MD 21205. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRole of the Apolipoprotein B–Apolipoprotein A-I Ratio in Cardiovascular Risk Assessment: A Case–Control Analysis in EPIC-Norfolk Wim A. van der Steeg , S. Matthijs Boekholdt , Evan A. Stein , Karim El-Harchaoui , Erik S.G. Stroes , Manjinder S. Sandhu , Nicholas J. Wareham , J. Wouter Jukema , Robert Luben , Aeilko H. Zwinderman , John J.P. Kastelein , and Kay-Tee Khaw Metrics Cited ByApolipoprotein B/A-I and total cholesterol/high-density lipoprotein cholesterol ratios both predict cardiovascular events in the general population independently of nonlipid risk factors, albuminuria and C-reactive proteinPrediction of Sudden Cardiac Death in Patients With Coronary Heart DiseaseAssociations of Characteristics of Renal Transplant Recipients With Clinicians' Perceptions of Adherence to Immunosuppressant Therapy 1 May 2007Volume 146, Issue 9Page: 677-679KeywordsApolipoproteinsCholesterolInfectious diseasesLipoproteinsMedical risk factorsRisk managementStable coronary artery disease ePublished: 1 May 2007 Issue Published: 1 May 2007 CopyrightCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...