Italian 
English DOCUMENTI - Documents
Volume:
Biochimica Clinica 2020; 44(3) 290-313
Pubblicato on-line:
Agosto 26, 2020
DOI:
10.19186/BC_2020.078
Quantificazione delle lipoproteine aterogeniche per le terapie ipolipemizzanti: Raccomandazioni di Consenso della European Atherosclerosis Society (EAS)e di EFLM
Quantifying atherogenic lipoproteins for lipid-lowering strategies: consensus-based recommendations from EAS and EFLM
AUTORI
Hannsjörg Baum6, Jan Borén and Olov Wiklund7,8, Eric Bruckert9, Alberico Catapano10,11, Christa Cobbaert12,
Paul Collinson13,14, Olivier S. Descamps15,16, Christopher J. Duff17, Arnold von Eckardstein18, Angelika Hammerer-Lercher19, Genovefa Kolovou20, Florian Kronenberg21
1Department of Laboratory Medicine, AZ St-Jan, Ruddershove 10, B-8000 Brugge, Belgium
2Herlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Denmark
3National Institute for Health and Medical Research (INSERM), Paris, France
4Endocrinology-Metabolism Service, Pitié-Salpetriere University Hospital, Paris, France
5Hormone Laboratory, Haukeland University Hospital, Bergen, Norway
6Institute for Laboratory Medicine, Mikrobiologie und Blutdepot, Regionale Kliniken Holding RKH GmbH, Ludwigsburg, Germany
7Institute of Medicine, Sahlgrenska Academy at Göteborg University, Gothenburg, Sweden
8Wallenberg Laboratory for Cardiovascular and Metabolic Research, Sahlgrenska University Hospital, Gothenburg, Sweden
9Department of Endocrinology and Prevention of Cardiovascular Disease, Pitié-Salpetriere University Hospital, Paris, France
10Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
11Multimedica, Milan, Italy
12Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands
13Department of Clinical Blood Sciences, St George’s University Hospitals NHS Foundation Trust and St George’s Universityof London, London, UK
14Department of Cardiology, St George’s University Hospitals NHS Foundation Trust and St George’s University of London,London, UK
15Department of Internal Medicine, Centres Hospitaliers Jolimont, Haine-Saint-Paul, Belgium
16Department of Cardiology, UCL Cliniques Universitaires Saint-Luc, Brussels, Belgium
17Department of Clinical Biochemistry, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
18Institute for Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland
19Kantonspital Aarau AG, Institute for Laboratory Medicine, Aarau, Switzerland
20Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece
21Department of Medical Genetics, Molecular and Clinical Pharmacology, Division of Genetic Epidemiology, Medical Universityof Innsbruck, Innsbruck, Austria
ABSTRACT
Quantifying atherogenic lipoproteins for lipid-lowering strategies: consensus-based recommendations from EAS and EFLM
The joint consensus panel of the European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) recently addressed present and future challenges in the laboratory diagnostics of atherogenic lipoproteins. Total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDLC), LDL cholesterol (LDLC), and calculated non-HDLC (=total – HDLC) constitute the primary lipid panel for estimating risk of atherosclerotic cardiovascular disease (ASCVD) and can be measured in the nonfasting state. LDLC is the primary target of lipidlowering therapies. For on-treatment follow-up, LDLC shall be measured or calculated by the same method to attenuate errors in treatment decisions due to marked between-method variations. Lipoprotein(a) [Lp(a)]- cholesterol is part of measured or calculated LDLC and should be estimated at least once in all patients at risk of ASCVD, especially in those whose LDLC declines poorly upon statin treatment. Residual risk of ASCVD even under optimal LDL-lowering treatment should be also assessed by non-HDLC or apolipoprotein B (apoB), especially in patients with mild-to-moderate hypertriglyceridemia (2–10 mmol/L). Non-HDLC includes the assessment of remnant lipoprotein cholesterol and shall be reported in all standard lipid panels. Additional apoB measurement can detect elevated LDL particle (LDLP) numbers often unidentified on the basis of LDLC alone. Reference intervals of lipids, lipoproteins, and apolipoproteins are reported for European men and women aged 20–100 years. However, laboratories shall flag abnormal lipid values with reference to therapeutic decision thresholds.