CLINICAL BRIEF 01 // PREVENTIVE LIPIDOLOGY

Why Standard Annual Physical LDL-C Misses Discordant ApoB & Lp(a) Risk

Helena Lindqvist, MD, FACC

Atherosclerotic plaque initiation scales directly with the molar concentration of apolipoprotein B-100 particles crossing the arterial endothelium—not cholesterol mass inside LDL.

Nearly 22% of metabolically active adults exhibit discordance between standard calculated LDL-C and actual ApoB particle count. Pairing ApoB quantification with once-in-a-lifetime genetic Lp(a) screening allows preventive cardiologists to stratify 30-year vascular risk decades before coronary calcification appears on CT.

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