No doubt, atherosclerotic cardiovascular disease (ASCVD) risk rises as the levels of low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non‑HDL-C) increase, and that the risk decreases as the levels of LDL-C and non-HDL-C decrease.

• It is not that LDL-C or non-HDL-C is ‘wrong’. They are merely less precise than apoB, and precision should matter in clinical care.
• Lab should report non-HDL-C in all; ApoB in selected cases.
• LAI recommendations 2020
• Elevated ApoB is a moderate nonconventional risk factor (a level >110 mg/dL) of apoB corresponds to (an LDL-C >130 mg/dL).
• To assess ASCVD risk, it is preferable to estimate serum apoB in patients with diabetes, metabolic syndrome, obesity, high TG concentration or very low LDL-C levels.
• ApoB measurement is recommended in high-risk subjects after LDL-C and non-HDL-C goals have been achieved. Discordant elevated apoB levels may identify individuals who have high residual cholesterol risk. This may warrant intensive statin therapy and the use of nonstatin drugs.
• Efforts should be made to gradually change the perception of the importance of apoB amongst physicians, patients and laboratories. Laboratories should standardize their methods.
• It would take time and efforts to introduce apoB estimation to be included in the standard lipid panel, initial and follow-up.
• The standard lipid panel for future screening, diagnosis and follow-up is likely to be TC, TG and apoB.