Extensive study confirms the benefit of testing apolipoproteins E, C-II and C-III to assess cardiac risk

Extensive study confirms the benefit of testing apolipoproteins E, C-II and C-III to assess cardiac risk

A study published on 21st February 2017 in the Journal of the American College of Cardiology has found that measuring apolipoproteins E, C-II and C-III can offer earlier detection of cardiovascular risk in comparison to routine apolipoprotein A-I and B tests.1

The lead author of the study, Professor Manuel Mayr, from King’s College London has said, “We directly compared the association of a broad panel of apolipoproteins to new onset of cardiovascular disease over a 10-year observation period, and found that while apoB was predictive, other apolipoproteins, namely apoE, apo C-II and apo C-III, were even better”. Professor Mayr further implied that the findings provide support that expanding current cardiac screening tests to include apolipoproteins could reduce risk of cardiovascular diseases.2

What are apolipoproteins?

Apolipoproteins are proteins that bind to lipids to form lipoproteins. Lipoproteins are made of proteins and fats, and serve the function of transporting insoluble fats, such as cholesterol and triglycerides, to be used by different cells. 3

There are six major types of apolipoprotein: A, B, C, D, E and H and the lipoproteins within these categories can vary in size, density and lipid composition. The study found that apolipoproteins E, C-II and C-III are linked to very low-density lipoproteins (vLDL) and have a stronger association with cardiovascular diseases in comparison to apolipoprotein A-I and apolipoprotein B.4

vLDL is strongly associated with the development of atherosclerosis, the build-up of fatty material inside the arteries, which is a major risk factor of cardiovascular diseases as it can lead to angina, heart attack, stroke or peripheral arterial disease.5

Why measure apo C-II, apo C-III and apo-E?

As highlighted by the authors of the study, cardiovascular risk assessment is commonly associated with only a few lipids within established lipoprotein classes, such as LDL.1 This emphasises the importance of carrying out detailed lipid testing to identify all subgroups to provide a complete cardiovascular risk assessment, as traditional biomarkers for lipids may only provide a limited overview. This can then allow for effective treatment to be provided at an earlier stage, which could subsequently reduce the risk of death by cardiovascular diseases.

Randox offer a range of routine and novel cardiac assays to provide a complete cardiac risk assessment, including: Apolipoprotein C-II / C-III / E / A-I / A-II /  B, Adiponectin, HDL Cholesterol, HDL3 Cholesterol, LDL Cholesterol, sLDL Cholesterol, Total Cholesterol, TxBCardio™, H-FABP, Homocysteine, hsCRP, Lipoprotein (a), sPLA2-IIA, and Triglycerides. For more information, email: reagents@randox.com.


1. Mayr, M. et al., Very-low-density lipoprotein-associated apolipoproteins predict cardiovascular events and are lowered by inhibition of APOC-III., Journal of the American College of Cardiology. Vol. 69, No. 7, 2017.

2. NIHR Biomedical Research Centre at Guy’s and St Thomas’ and King’s College London, Discovery could help doctors to spot cardiovascular disease at an earlier stage: Advanced technologies provide researchers with new insights into the warning signs for cardiovascular disease, ScienceDaily (2017) Available from: https://goo.gl/XkC23R [Accessed: 21 February 2017]

3. Kingsbury, K. J., Understanding the Essentials of Blood Lipid Metabolism, Medscape, (2017) Available from: https://goo.gl/AApW6S [Accessed: 23 February 2017]

4. Wallace, A., New technique could aid in earlier diagnosis of heart disease, UPI, (2017) Available from: https://goo.gl/xzxLdf [Accessed: 23 February 2017]

5. British Heart Foundation, Atherosclerosis, (2017) Available from: https://goo.gl/1qHxpk [Accessed: 23 February 2017}

Apolipoproteins may offer earlier detection of CVDs

Clinical Laboratory Survey