To: Didi who wrote (308 ) 12/15/2001 8:37:55 PM From: SIer formerly known as Joe B. Read Replies (5) | Respond to of 2067 Study: Cholesterol Not Best Measure of Heart Risk Friday December 14 5:28 AM ET dailynews.yahoo.com By Patricia Reaney LONDON (Reuters) - Measuring proteins could be more accurate than monitoring cholesterol levels in identifying people most likely to have a fatal heart attack, Swedish scientists said Friday. High levels of cholesterol are a major warning sign of heart disease, but researchers at the Karolinska Institute and Anglo-Swedish drugs group AstraZeneca said amounts of two apolipoproteins, apoB and apoA-1, could be an even better indicator. ``With this new type of test we can better define who should be treated and who should not be treated (for heart disease),'' said Dr. Goran Walldius of the Karolinska Institute in Stockholm. Like good and bad cholesterol, the balance between the two proteins could be the key to diagnosing and possibly, in the future, treating heart disease. Cholesterol can clog the arteries and contribute to heart disease. Bad cholesterol deposits fat and good cholesterol carries fat away. Walldius said apoB and apoA-1 give a more accurate risk profile than cholesterol levels, particularly in people over 70. ApoB is produced by the liver and acts like a chauffeur, transporting cholesterol to different sites in the body. ApoA-1 is also manufactured in the liver. It can pick up high levels of cholesterol in cells and take them back to the liver, where they are destroyed. ``Stimulating apoA-1 is one way of treating atherosclerosis (narrowing of the arteries) and reducing risk,'' Walldius said in a telephone interview. GOOD AND BAD CHOLESTEROL In research reported in the Lancet medical journal, the scientists studied data on levels of good and bad cholesterol and apoB and apoA-1 from 175,000 Swedish people. After a follow-up study of more than five years, they found that a high apoB/apoA-1 ratio was strongly linked to an increased risk of a fatal heart attack and high levels of apoA-1 had a protective effect. In both men and women, apoB was a stronger predictor of heart attack risk than bad cholesterol levels. Walldius said new drugs that could reduce apoB and increase apoA-1 could be a new defense against heart disease. ``The most important thing is to get the correct balance between these particles,'' he explained. Walldius said levels of the protein in blood can be easily measured with a simple test that is accurate, precise, fast and inexpensive. In a commentary on the research, Gerald Berenson of Tulane University in New Orleans said the study underscored the potential use of apoB and apoA-1 in evaluating the risk and preventing coronary artery disease. But he added that more research was needed before the proteins could be used in diagnostic tests and treatments.