Heart disease: Is this protein test a better predictor of risk than cholesterol levels?

The test can be used to identify more patients at risk for heart disease.

A blood test for a certain protein may do a better job at detecting heart disease than only measuring cholesterol levels, according to an analysis published in the Journal of the American College of Cardiology.

The test measures levels of apolipoprotein B-100 (ApoB). This protein attaches to disease-promoting cholesterol or LDL cholesterol.
HDL cholesterol or good cholesterol does not carry protein.

It’s widely known that LDL cholesterol — aka bad cholesterol — can cause atherosclerosis or plaque buildup in the arteries. A common test for LDL cholesterol levels can measure the mass of this “bad” cholesterol in the body, but the protein test will actually get the results for the number of particles.

According to the findings, the test can be used to identify more patients at risk for heart disease, especially those whose cholesterol levels appear normal.

“This study highlights an important tool that could potentially help us keep patients out of the hospital for cardiovascular events such as heart attacks and strokes while in addition helping to lower the overall incidence of atherosclerotic heart disease,” says Wafi Momin, DO, a cardiologist with UTHealth Houston Heart & Vascular and Memorial Hermann.

How an ApoB test can predict heart disease risk

Using the health data of 705 individuals collected between 2010 and 2022, the researchers evaluated how many of the patients were tested for ApoB and LDL cholesterol levels.

Though the frequency of ApOb testing increased during the study period, the researchers found that the test is still underutilized.

The team also found that 46% of the patients had elevated ApoB levels, even when their LDL cholesterol levels were considered to be in the healthy range.