The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index; 10 of the 13 sources its claims cite were checked for support.
Association of Apolipoprotein B–Containing Lipoproteins and Risk of Myocardial Infarction in Individuals With and Without Atherosclerosis
Open accessAbstract
IMPORTANCE: Lipid management typically focuses on levels of low-density lipoprotein cholesterol (LDL-C) and, to a lesser extent, triglycerides (TG). However, animal models and genetic studies suggest that the atherogenic particle subpopulations (LDL and very-low-density lipoprotein [VLDL]) are both important and that the number of particles is more predictive of cardiac events than their lipid content. OBJECTIVE: To determine whether common measures of cholesterol concentration, TG concentration, or their ratio are associated with cardiovascular risk beyond the number of apolipoprotein B (apoB)-containing lipoproteins. DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort analysis included individuals from the population-based UK Biobank and from 2 large international clinical trials, FOURIER and IMPROVE-IT. The median (IQR) follow-up was 11.1 (10.4-11.8) years in UK Biobank and 2.5 (2.0-4.7) years in the clinical trials. Two populations were studied in this analysis: 389 529 individuals in the primary prevention group who were not taking lipid-lowering therapy and 40 430 patients with established atherosclerosis who were receiving statin treatment. EXPOSURES: ApoB, non-high-density lipoprotein cholesterol (HDL-C), LDL-C, and TG. MAIN OUTCOME AND MEASURES: The primary study outcome was incident myocardial infarction (MI). RESULTS: Of the 389 529 individuals in the primary prevention group, 224 097 (58%) were female, and the median (IQR) age was 56.0 (49.5-62.5) years. Of the 40 430 patients with established atherosclerosis, 9647 (24%) were female, and the median (IQR) age was 63 (56.2-69.0) years. In the primary prevention cohort, apoB, non-HDL-C, and TG each individually were associated with incident MI. However, when assessed together, only apoB was associated (adjusted hazard ratio [aHR] per 1 SD, 1.27; 95% CI, 1.15-1.40; P < .001). Similarly, only apoB was associated with MI in the secondary prevention cohort. Adjusting for apoB, there was no association between the ratio of TG to LDL-C (a surrogate for the ratio of TG-rich lipoproteins to LDL) and risk of MI, implying that for a given concentration of apoB-containing lipoproteins, the relative proportions of particle subpopulations may no longer be a predictor of risk. CONCLUSIONS AND RELEVANCE: In this cohort study, risk of MI was best captured by the number of apoB-containing lipoproteins, independent from lipid content (cholesterol or TG) or type of lipoprotein (LDL or TG-rich). This suggests that apoB may be the primary driver of atherosclerosis and that lowering the concentration of all apoB-containing lipoproteins should be the focus of therapeutic strategies.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
In a large primary-prevention cohort and two secondary-prevention trial cohorts, apolipoprotein B (apoB) was the only lipid parameter independently associated with myocardial infarction after full adjustment. Neither lipid content nor lipoprotein type added risk beyond the number of apoB-containing particles.
Key findings
In 389,529 primary-prevention individuals not on lipid-lowering therapy, apoB, non–HDL-C, and TG were each individually associated with incident MI, but after full adjustment only apoB remained associated (aHR per 1 SD, 1.27; 95% CI, 1.15-1.40; P < .001).
- In the same cohort, TG was associated with MI in clinically adjusted models (aHR per 1 SD, 1.16; 95% CI, 1.13-1.19; P < .001), but not after full clinical and lipid adjustment (aHR per 1 SD, 1.00; 95% CI, 0.96-1.04; P = .71).
- In 40,430 patients with established atherosclerosis receiving statin treatment, only apoB was associated with MI; TG was not associated in clinically adjusted (aHR per 1 SD, 1.03; 95% CI, 0.99-1.07) or clinically and lipid-adjusted models (aHR per 1 SD, 0.94; 95% CI, 0.89-1.00).
- Adjusting for apoB, the TG/LDL-C ratio was not associated with MI (aHR per 1 SD, 1.04; 95% CI, 0.99-1.09; P = .12), suggesting that for a given concentration of apoB-containing lipoproteins, particle type did not confer additional risk.
Methods
Prospective cohort analysis using UK Biobank primary-prevention individuals without lipid-lowering therapy (n = 389,529) and pooled secondary-prevention patients with established atherosclerosis from FOURIER and IMPROVE-IT receiving lipid-lowering therapy (n = 40,430). Median follow-up was 11.1 years in UK Biobank and 2.5 years in the clinical trials.
- Exposures were apoB, non–HDL-C, LDL-C, and TG; the primary outcome was fatal or nonfatal MI.
- Cox proportional hazards models estimated adjusted hazard ratios per 1 SD higher lipid parameter, with clinical adjustment and further adjustment for HDL-C, TG, non–HDL-C, and apoB; the TG/LDL-C ratio was evaluated with adjustment for apoB.
Limitations
The paper states that lipid values were measured using conventional lipid profiles rather than nuclear magnetic resonance spectroscopy, which would more accurately determine the VLDL-to-LDL ratio than the TG/LDL-C surrogate used.
- The paper states that UK Biobank lipid values and lipid-lowering therapy data were collected at baseline and may have changed during follow-up; because individuals with higher lipid values would be most likely to start lipid-lowering therapy, this may have attenuated associations. The study was also not enriched for severe hypertriglyceridemia.
- Evident from the text: the analysis is observational, limiting causal inference; the trial cohorts excluded patients with TG ≥400 mg/dL in FOURIER and ≥350 mg/dL in IMPROVE-IT, so severe hypertriglyceridemia is not represented.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
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Cites
Statistics
Verification
Claims the paper makes
35 Own result · 9 Own interpretation · 8 Own method · 5 No basis given · 4 Supported · 2 Partly supported · 2 No full text of the sources · accuracy not yet measured
Every source the paper cites for this claim was checked and supports it.
In the paper
“Mendelian randomization studies have shown that apoB is a better predictor of coronary artery disease risk than serum LDL-C or TG concentration”
What the sources say
- Supportedcites [4] Ference, 2019, Association of triglyceride-lowering LPL variants and LDL-C–lowering LDLR variants with risk of coronary heart disease., JAMA source
The Abstract reports that, in multivariable Mendelian randomization analyses, the associations of triglycerides and LDL-C with coronary heart disease risk became null after adjustment for ApoB, while the ApoB association remained. The Discussion likewise says risk appears to be determined by ApoB-containing particle concentration rather than the cholesterol or triglyceride mass those particles carry. The supplied passages do not give page numbers. (LLM, conf=0.92)
- Supportedcites [5] Richardson, 2020, Evaluating the relationship between circulating lipoprotein lipids and apolipoproteins with risk of coronary heart disease: a multivariable mendelian randomisation analysis., PLoS Med source
The Results section (“Appraisal of LDL cholesterol, triglycerides, and apolipoprotein B”) reports that only apoB retained a robust association with coronary heart disease when all three traits were assessed together in multivariable Mendelian randomisation. The Introduction also describes apoB as having a stronger association with cardiovascular risk than LDL cholesterol and notes a modest improvement in predictive performance when apoB-related measures are included. (LLM, conf=0.87)
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“This study builds on prior work showing that apoB concentration is the most predictive parameter of CV risk,13,14,15”
What the sources say
- Partly supportedcites [13] Lawler, 2017, Discordance between circulating atherogenic cholesterol mass and lipoprotein particle concentration in relation to future coronary events in women., Clin Chem sourceExperimental — accuracy not yet measured
The Discussion (page not supplied) reports that, among women whose apoB and non-HDL cholesterol measurements were discordant, coronary heart disease risk tracked more closely with lipoprotein particle concentration, particularly apoB. It does not establish that apoB is the most predictive parameter of cardiovascular risk generally, across populations and risk measures. (LLM, conf=0.88)
- Partly supportedcites [14] Johannesen, 2021, Apolipoprotein B and non-HDL Cholesterol better reflect residual risk than LDL cholesterol in statin-treated patients., J Am Coll Cardiol sourceExperimental — accuracy not yet measured
The Conclusions report that apoB was a more accurate marker of all-cause mortality risk than LDL or non-HDL cholesterol in statin-treated patients, and of myocardial infarction risk than LDL cholesterol. The claim broadens those comparisons to call apoB the most predictive parameter of cardiovascular risk generally; the cited paper does not establish that broader ranking. (LLM, conf=0.87)
- Partly supportedcites [15] Sniderman, 2019, Apolipoprotein B particles and cardiovascular disease: a narrative review., JAMA Cardiol sourceExperimental — accuracy not yet measured
The Introduction reports that discordance analyses found apoB more accurate than LDL-C and non-HDL-C for predicting cardiovascular risk attributable to apoB lipoprotein particles. It does not establish apoB as the most predictive parameter of cardiovascular risk overall; it also notes studies finding apoB and non-HDL-C equivalent predictors. (LLM, conf=0.84)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the primary prevention cohort, apoB, non–HDL-C, and TG each individually were associated with incident MI.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and while this was maintained after adding TG to the model”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This significant positive association was maintained after full adjustment for lipid parameters, including TG, non–HDL-C, and HDL-C (HR, 1.27; 95% CI, 1.15-1.40; P < .001) (Figure 1B).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“ApoB, LDL-C, and non–HDL-C were correlated (ρ ≥ 0.95).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the primary prevention cohort, apoB, non–HDL-C, and TG each individually were associated with incident MI.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the primary prevention cohort, apoB, non–HDL-C, and TG each individually were associated with incident MI.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Similarly, only apoB was associated with MI in the secondary prevention cohort.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“non–HDL-C was no longer associated with MI when adjusted for apoB (Table 2).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Probably not a substantial claim. 19
- It may state two separate claims as one. 14
Every source the paper cites for this claim was checked and supports it.
In the paper
“suggesting that the number of atherogenic particles may be the driver of cardiovascular risk, rather than cholesterol or TG content per se.4,5”
What the sources say
- Supportedcites [4] Ference, 2019, Association of triglyceride-lowering LPL variants and LDL-C–lowering LDLR variants with risk of coronary heart disease., JAMA source
The Discussion states that cardiovascular risk appears to be determined by the circulating concentration of ApoB-containing particles rather than the mass of cholesterol or triglyceride they carry. It also explains that particle concentration determines how many particles become retained in the artery wall. This supports the citing sentence’s hedged claim. (LLM, conf=0.94)
- Supportedcites [5] Richardson, 2020, Evaluating the relationship between circulating lipoprotein lipids and apolipoproteins with risk of coronary heart disease: a multivariable mendelian randomisation analysis., PLoS Med source
The Discussion states that apolipoprotein B indexes the number of atherogenic particles and that this number, rather than circulating cholesterol or triglycerides per se, is the important driver of coronary heart disease. The claim’s cautious wording is consistent with the paper’s conclusion. (LLM, conf=0.95)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“These studies have suggested that TG and remnant cholesterol may be more potent risk factors for myocardial infarction (MI) than LDL-C is.2,3”
What the sources say
- Not checked — no full text of the sourcecites [2] Castañer, 2020, Remnant cholesterol, not LDL cholesterol, is associated with incident cardiovascular disease., J Am Coll Cardiol source
- Partly supportedcites [3] Balling, 2020, VLDL cholesterol accounts for one-half of the risk of myocardial infarction associated with apoB-containing lipoproteins., J Am Coll Cardiol sourceExperimental — accuracy not yet measured
The paper’s Abstract (page unavailable) reports that VLDL cholesterol explained 50% of the myocardial-infarction risk associated with apoB-containing lipoproteins, compared with 29% for IDL plus LDL cholesterol. This supports the remnant-cholesterol portion of the claim. It does not support the triglyceride portion: the same passage says VLDL triglycerides did not explain that risk. (LLM, conf=0.88)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
Every source the paper cites for this claim was checked and supports it.
In the paper
“However, it should be recognized that these measures do not identify the number of apoB-containing lipoprotein particles as reliably and have been shown to not always accurately predict CV risk.17”
What the sources say
- Supportedcites [17] Mora, 2014, Discordance of low-density lipoprotein (LDL) cholesterol with alternative LDL-related measures and future coronary events., Circulation source
The Discussion explains that LDL-C and non-HDL-C measure cholesterol carried by particles, whereas apoB reflects the number of apoB-containing particles. The Results and Discussion report that relying on LDL-C alone can under- or overestimate coronary risk when LDL-related measures are discordant. The study assessed coronary events in initially healthy women. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“While such an approach can specifically measure the number and particle size of lipoprotein particles, prior studies have shown that they are not superior to conventional lipid profiles.22”
What the sources say
- Supportedcites [22] Mora, 2009, Lipoprotein particle profiles by nuclear magnetic resonance compared with standard lipids and apolipoproteins in predicting incident cardiovascular disease in women., Circulation source
The Discussion reports that, in a prospective cohort of initially healthy women, NMR-measured lipoproteins predicted incident cardiovascular disease comparably to, but not better than, standard lipids. This supports the cited comparison for CVD risk prediction; the paper does not establish that NMR is inferior for every clinical use or population. (LLM, conf=0.91)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“TG was positively correlated with these 3 parameters (ρ = 0.38-0.52).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and negatively correlated with TG (ρ = −0.49).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“HDL-C was correlated with apoB, LDL-C, and non–HDL-C (ρ ≤ |0.12|)”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“First, apoB was the only independent driver of lipid-associated MI risk, confirming the importance of particle concentration.”
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: ApoB is in a 1:1 association with atherogenic lipoprotein particles.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In individuals not receiving lipid-lowering therapy, the median (IQR) TG/LDL-C ratio was 0.39 (0.29-0.55).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Each of these findings was consistent across both primary and secondary populations and in those receiving and not receiving lipid lowering therapy.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This flat association was seen up to TG/LDL-C ratios of 2 in the clinical trials, where LDL-C lowering therapies lowered LDL-C, resulting in much higher TG/LDL-C ratios (eFigure 2 in the Supplement).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and further advances our understanding by demonstrating that LDL-C and TG levels do not have predictive value beyond apoB.”
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“LDL-C and non–HDL-C are correlated with apoB, and therefore can be used to approximate lipoprotein particle concentration and CV risk when apoB is not available.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A sensitivity analysis using a broader composite atherosclerotic cardiovascular disease end point was performed in each cohort.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In FOURIER and IMPROVE-IT, MI was a component of the trials’ primary end points and was therefore adjudicated by the Thrombolysis in Myocardial Infarction (TIMI) central clinical end points committee. Adjudicators were blinded to lipid levels and treatment arm.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Nonetheless, nuclear magnetic resonance spectroscopy would offer a more accurate method for determining the VLDL-to-LDL ratio compared with the surrogate of TG to LDL-C used in this study.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Because individuals with higher lipid values would be most likely to start lipid-lowering therapy, we anticipate this may have attenuated the association for each lipid parameter.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Rests on an assumption: Individuals with higher lipid values are most likely to start lipid-lowering therapy.
In the paper
“but the American Association of Clinical Chemistry has stated that apoB is standardized and can be measured with more accuracy than LDL-C and non–HDL-C.21”
What the sources say
- Not checked — no full text of the sourcecites [21] Cole, 2013, Association of apolipoprotein B and nuclear magnetic resonance spectroscopy-derived LDL particle number with outcomes in 25 clinical studies: assessment by the AACC Lipoprotein and Vascular Diseases Division Working Group on Best Practices., Clin Chem source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Lipid values in these cohorts were measured using conventional lipid profiles rather than nuclear magnetic resonance spectroscopy.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Moreover, our study was not enriched for patients with severe hypertriglyceridemia, so we cannot comment on risk associations in such individuals.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Conversely, 2 individuals can have the same apoB levels (and hence the same number of atherogenic lipoproteins). An individual with lower LDL-C, the metric on which the field currently focuses, may be perceived as being at lower risk, but that is not necessarily the case.”
hedgedn = 2- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: ApoB is in a 1:1 association with atherogenic lipoprotein particles.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, these studies have limitations that include incomplete model adjustment, residual confounding, and not accounting for the concentration of lipoprotein particles as measured by apoB.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“These findings are of increased relevance as recent publications have reported that TG, rather than LDL-C, most strongly predict CV risk.2”
What the sources say
- Not checked — no full text of the sourcecites [2] Castañer, 2020, Remnant cholesterol, not LDL cholesterol, is associated with incident cardiovascular disease., J Am Coll Cardiol source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“ApoB allows for accurate assessment of particle concentration, and when it is held constant, the measurements of TG and LDL-C reflect particle type and content.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: ApoB is in a 1:1 association with atherogenic lipoprotein particles.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Additionally, lipid values and lipid-lowering therapy data were collected at baseline in UK Biobank, but may have changed in some individuals during the follow-up period.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Indeed, LDL-C is often calculated by laboratories rather than directly measured, which may contribute to less accurate measurements compared with those for apoB and support more widespread use of apoB.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“we addressed the issue by running a bootstrapped version of an adjusted Cox regression for the risk of MI, including all the lipids under examination (apoB, TG, non–HDL-C, and HDL).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The paper relies on this without support.
There is exactly one apoB-100 molecule on each atherogenic apoB-containing particle (LDL, IDL, and VLDL).
“As there is exactly 1 apoB-100 on each of the atherogenic apoB-containing particles (ie, LDL, IDL, and VLDL)”
The paper relies on this without support.
Measures of cholesterol and triglycerides provide information on the lipids in the blood and thus only indirectly on the types of lipoproteins and their composition, and not on the number of lipoproteins.
“However, measures of cholesterol and TG provide information on the lipids in the blood and thus only indirectly on the types of lipoproteins and their composition, and not on the number of lipoproteins.”
The paper relies on this without support.
Fatal or nonfatal myocardial infarction can be known with high precision and is strongly associated with dyslipidemia.
“The end point of interest in both cohorts was fatal or nonfatal MI, a cardiovascular outcome that can be known with high precision and is strongly associated with dyslipidemia.”
The paper relies on this without support.
The ratio of triglycerides to LDL-C is a surrogate for the ratio of triglyceride-rich lipoproteins to LDL.
“the ratio of TG to LDL-C (a surrogate for the ratio of TG-rich lipoproteins to LDL)”
The paper relies on this without support.
ApoB is in a 1:1 association with atherogenic lipoprotein particles.
“given the 1:1 association between apoB and atherogenic lipoprotein particles.”
The paper relies on this without support.
TG estimates TG-rich lipoproteins (VLDL and IDL) and LDL-C estimates LDL particles.
“TG-rich lipoproteins (ie, VLDL and IDL, estimated by TG) or LDL particle (estimated by LDL-C).”
The paper relies on this without support.
Individuals with higher lipid values are most likely to start lipid-lowering therapy.
“Because individuals with higher lipid values would be most likely to start lipid-lowering therapy”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Conclusions
“eTable 4. Baseline lipid parameters and adjusted hazard ratios for the composite endpoint myocardial infarction, stroke or cv death in the secondary prevention cohort without lipid lowering therapy”
§ Methods
“The second group included 40 430 patients with established atherosclerosis disease who were receiving lipid-lowering therapy”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Discussion
“In this study, all lipid-adjusted analyses included adjustment for apoB, thereby accounting for lipoprotein particle concentration in the risk assessment.”
§ Results
“Non–HDL-C had similar MI association with clinical adjustment, and while this was maintained after adding TG to the model, non–HDL-C was no longer associated with MI when adjusted for apoB (Table 2).”
Citations
Cites
Sudlow, C., Gallacher, J., Allen, N., Beral, V., Burton, P., Danesh, J., Downey, P., Elliott, P., Green, J., Landray, M., et al. (2015) · PLOS Medicine · doi:10.1371/journal.pmed.1001779 · Cited by 12,728
Mach, F., Baigent, C., Catapano, A. L., Koskinas, K. C., Casula, M., Badimon, L., Chapman, M. J., De Backer, G. G., Delgado, V., Ference, B. A., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehz455 · Cited by 8,961
Self-citationThe UK Biobank resource with deep phenotyping and genomic data
Bycroft, C., Freeman, C., Petkova, D., Band, G., Elliott, L. T., Sharp, K., Motyer, A., Vukcevic, D., Delaneau, O., O’Connell, J., et al. (2018) · Nature · doi:10.1038/s41586-018-0579-z · Cited by 8,876
Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease
Sabatine, M. S., Giugliano, R. P., Keech, A. C., Honarpour, N., Wiviott, S. D., Murphy, S. A., Kuder, J. F., Wang, H., Liu, T., Wasserman, S. M., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1615664 · Cited by 6,138
Self-citationMach, F., Baigent, C., Catapano, A. L., Koskinas, K. C., Casula, M., Badimon, L., Chapman, M. J., De Backer, G. G., Delgado, V., Ference, B. A., et al. (2019) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2019.08.014 · Cited by 4,854
Self-citationEzetimibe Added to Statin Therapy after Acute Coronary Syndromes
Cannon, C. P., Blazing, M. A., Giugliano, R. P., McCagg, A., White, J. A., Theroux, P., Darius, H., Lewis, B. S., Ophuis, T. O., Jukema, J. W., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1410489 · Cited by 4,487
Self-citationKANNEL, W. B., DAWBER, T. R., KAGAN, A., REVOTSKIE, N., & STOKES, J. (1961) · Annals of Internal Medicine · doi:10.7326/0003-4819-55-1-33 · Cited by 1,837
Elliott, P., Peakman, T. C., & Biobank, O. B. O. U. (2008) · International Journal of Epidemiology · doi:10.1093/ije/dym276 · Cited by 1,004
Richardson, T. G., Sanderson, E., Palmer, T. M., Ala-Korpela, M., Ference, B. A., Davey Smith, G., & Holmes, M. V. (2020) · PLOS Medicine · doi:10.1371/journal.pmed.1003062 · Cited by 843
Self-citationBoekholdt, S. M., Arsenault, B. J., Mora, S., Pedersen, T. R., LaRosa, J. C., Nestel, P. J., Simes, R. J., Durrington, P., Hitman, G. A., Welch, K. M. A., et al. (2012) · JAMA · doi:10.1001/jama.2012.366 · Cited by 795
Cited by
Sorted by citations
Items 101–200 of 261
Zhu, B., Cao, C., Liu, W., Liu, Y., Luo, Y., & Peng, D. (2024) · Diabetes & Metabolic Syndrome Clinical Research & Reviews · doi:10.1016/j.dsx.2024.103182 · Cited by 9
Filtz, A., Shapiro, M. D., Whelton, P. K., Návar, A. M., Rodríguez, F., Martin, S. S., Gulati, M., Blankstein, R., Ridker, P. M., Bhatt, D. L., et al. (2025) · American Journal of Preventive Cardiology · doi:10.1016/j.ajpc.2025.101357 · Cited by 9
“Evidence supporting apoB as a primary target: 1) ApoB is a superior marker of lipid-related risk than LDL-C in most observational analyses, including in both untreated primary prevention populations and on-treatment analyses from secondary prevention trials [24].”
Phenome-wide Mendelian randomization study of plasma triglyceride levels and 2600 disease traits
Park, J. K., Bafna, S., Forrest, I. S., Duffy, Á., Márquez‐Luna, C., Petrazzini, B. O., Vy, H. M. T., Jordan, D. M., Verbanck, M., Narula, J., et al. (2023) · eLife · doi:10.7554/elife.80560 · Cited by 9
Self-citationVelilla, T. A., Guijarro, C., Ruíz, R. C., Piñero, M. R., Marcos, J. F. V., López, A. M. B., López, A. M., Donaire, J. A. G., Obaya, J. C., Guerra, L. C., et al. (2023) · Nefrología (English Edition) · doi:10.1016/j.nefroe.2023.08.002 · Cited by 10
Shi, M., Zhu, X., Cheang, I., Zhu, Q., Guo, Q., Liao, S., Gao, R., & Li, X. (2022) · Environmental Science and Pollution Research · doi:10.1007/s11356-022-23296-y · Cited by 9
Deng, K., Pan, X., Voehler, M., Cai, Q., Cai, H., Shu, X., Gupta, D. K., Lipworth, L. P., Zheng, W., & Yu, D. (2024) · Journal of the American Heart Association · doi:10.1161/jaha.124.034364 · Cited by 8
“Findings from large cohorts, including the AMORIS (Apolipoprotein-Related Mortality Risk) study, 49 National Health and Nutrition Examination Survey, 13 Framingham Offspring Cohort, 50 MESA (Multi-Ethnic Study of Atherosclerosis), 25 CKB (China Kadoorie Biobank), 22 and UK Biobank, 19,51 have consistently demonstrated…”
BackgroundDiretriz Brasileira de Dislipidemias e Prevenção da Aterosclerose – 2025
Rached, F. H., Miname, M. H., Rocha, V. Z., Zimerman, A., Cesena, F. Y., Sposito, A. C., Santos, R. D., Behr, P. E. B., Bianco, H. T., Alves, R. J., et al. (2025) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20250640 · Cited by 42
High LDL Particle and APOB Concentrations in Patients With Adrenal Cortical Adenomas
Sandooja, R., Saini, J., Kittithaworn, A., Garcia, R. G., Dogra, P., Atkinson, E. J., Yu, K., Fell, V. M., Simha, V., Connelly, M. A., et al. (2024) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgae392 · Cited by 8
Schwarz, A., Demuth, I., Landmesser, U., Haghikia, A., König, M., & Steinhagen‐Thiessen, E. (2022) · Lipids in Health and Disease · doi:10.1186/s12944-022-01708-9 · Cited by 8
The Lower the ApoB, the Better: Now, How Does ApoB Fit in the Upcoming Era of Targeted Therapeutics?
Elshazly, M. B., & Quispe, R. (2022) · Circulation · doi:10.1161/circulationaha.122.061188 · Cited by 8
Kenkre, J. S., Mazaheri, T., Neely, R. D. G., Soran, H., Datta, D. B. N., Penson, P. E., Downie, P., Yates, A. M., Hayden, K., Patel, M., et al. (2025) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1177/00045632251315303 · Cited by 8
“122 Furthermore, when ApoB and LDL-c are discordant, the cardiovascular outcome has been found to be more likely to follow the ApoB result.”
Cardiovascular disease lipids and lipoproteins biomarker standardization
Lyle, A. N., Danilenko, U., Sugahara, O., & Vesper, H. W. (2025) · Critical Reviews in Clinical Laboratory Sciences · doi:10.1080/10408363.2025.2462817 · Cited by 7
Epstein, E., Ekpo, E., Evans, D., Varughese, E. B., Hermel, M., Jeschke, S., Hassan, S., Torkamani, A., Muse, E. D., & Triffon, D. W. (2025) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwaf554 · Cited by 7
Not all fibrates are made equal: Learning from biology and clinical trials
Zambon, A., Staels, B., Farnier, M., Vrablík, M., & Catapano, A. L. (2025) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2025.120555 · Cited by 8
Anderson, J. L., Knight, S., May, H. T., Le, V. T., Bair, T. L., Knowlton, K. U., & Muhlestein, J. B. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12093263 · Cited by 7
Increasing the complexity of lipoprotein characterization for cardiovascular risk in type 2 diabetes
Guardiola, M., Rehues, P., Amigó, N., Arrieta, F., Botana, M., Gimeno-Orna, J. A., Girona, J., Martínez‐Montoro, J. I., Ortega, E., Pérez, A., et al. (2024) · European Journal of Clinical Investigation · doi:10.1111/eci.14214 · Cited by 7
“ApoB has been proven to be a better predictor of myocardial infarction and ASCVD than LDLc and non-HDLc 29,30 3.”
Muro, F. M. D., Crociani, M. F., Nardi, G., Ciardetti, N., Biagiotti, L., Bigi, E., Meucci, F., Stolcova, M., Ristalli, F., Cecchi, E., et al. (2024) · Catheterization and Cardiovascular Interventions · doi:10.1002/ccd.31363 · Cited by 8
“Indeed, apo(B) may be the primary responsible for driving atherosclerosis progression due to its similarity to LDL [25].”
Tong, B., Long, C., Zhang, J., Zhang, X., Li, Z., Qi, H., Su, K., Zhang, D., Chen, Y., Ling, J., et al. (2024) · Lipids in Health and Disease · doi:10.1186/s12944-024-02337-0 · Cited by 6
“The presence of atherogenic lipoproteins, including VLDL, further relates to cardiovascular risks, which may also impact ocular health [70].”
BackgroundChen, X., Sun, M., Ma, X., Ma, Y., & Chen, B. (2024) · Molecular Therapy — Methods & Clinical Development · doi:10.1016/j.omtm.2024.101390 · Cited by 6
Singh, B., Tzoulaki, I., & Mayr, M. (2025) · Cardiovascular Research · doi:10.1093/cvr/cvaf167 · Cited by 6
Monoclonal Anti-PCSK9 Antibodies: Real-World Data
Guidotti, G., Liberati, V., Sorrentino, A., Lotti, E., Crudele, F., Rogolino, A. A., Sammartino, A., Slanzi, M., Gori, A. M., Marcucci, R., et al. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13154543 · Cited by 7
“LDL cholesterol (LDL-C) is one of the main modifiable cardio-vascular risk (CV) factors, since the accumulation of LDL-C and other apo-B-containing lipoproteins is a key event in the initiation and progression of the atherosclerotic process [2,3].”
BackgroundCole, J., Couture, P., Tremblay, A. J., & Sniderman, A. D. (2024) · Journal of clinical lipidology · doi:10.1016/j.jacl.2024.09.009 · Cited by 6
Apolipoprotein B modifies the association between lipoprotein(a) and ASCVD risk
Lai, Y., Zhang, S., Guo, Y., Xu, C., Huang, M., Zhan, R., Liu, M., Xiong, Z., Huang, Y., Liao, X., et al. (2024) · American Heart Journal · doi:10.1016/j.ahj.2024.11.014 · Cited by 6
Chen, X., Huang, J., Liang, J., Li, L., & Deng, K. (2022) · Urology · doi:10.1016/j.urology.2022.11.011 · Cited by 6
Design, synthesis, and biological evaluation of novel atorvastatin derivatives
Najafi, S., Moshtaghie, A. A., Hassanzadeh, F., et al. (2023) · Journal of Molecular Structure · doi:10.1016/j.molstruc.2023.135229 · Cited by 6
Velilla, T. A., Guijarro, C., Ruíz, R. C., Piñero, M. R., Marcos, J. F. V., Pérez, A., López, M. A. B., López, A. M., Donaire, J. A. G., Obaya, J. C., et al. (2023) · Clínica e Investigación en Arteriosclerosis · doi:10.1016/j.arteri.2022.10.002 · Cited by 15
Zhu, K., Hou, Z., Huang, C., Xu, M., Mu, L., Yu, G., Kaufman, J. D., Wang, M., & Lü, B. (2023) · Environmental Research · doi:10.1016/j.envres.2023.116334 · Cited by 8
Schreiner, T. G., Ignat, B. E., Grosu, C., Costache, A. D., Leon, M. M., & Mitu, F. (2024) · Medicina · doi:10.3390/medicina60040561 · Cited by 6
“A similar tendency was observed in another cohort, where ApoB was the only biomarker significantly associated with incident myocardial infarction in fully adjusted models [74].”
ResultManikpurage, H. D., Ricard, J., Houessou, U., Bourgault, J., Gagnon, É., Gobeil, É., Girard, A. S., Li, Z., Eslami, A., Mathieu, P., et al. (2024) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2024.119083 · Cited by 6
Maidman, S. D., & Rosenson, R. S. (2025) · BioDrugs · doi:10.1007/s40259-025-00731-3 · Cited by 7
Reijnders, E., Bossuyt, P. M., Jukema, J. W., Ruhaak, L. R., Romijn, F. P. H. T. M., Szarek, M. J., Trompet, S., Bhatt, D. L., Bittner, V., Díaz, R., et al. (2025) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/atvbaha.124.322336 · Cited by 6
Velilla, T. A., Guijarro, C., Ruíz, R. C., Piñero, M. R., Marcos, J. F. V., Pérez, A., López, A. M. B., López, A. M., Donaire, J. A. G., Obaya, J. C., et al. (2023) · Advances in Laboratory Medicine / Avances en Medicina de Laboratorio · doi:10.1515/almed-2023-0047 · Cited by 5
Shi, L., Li, G., Hou, N., Tu, L., Li, J., Luo, J., & Hu, S. (2024) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2024.176619 · Cited by 5
Walker, M., Riggs, K. A., Rohatgi, A. K., Beckman, J. A., Addo, T. A., Girotra, S. R., Bonaca, M. P., Armstrong, E. J., & Kumbhani, D. J. (2025) · Journal of the American Heart Association · doi:10.1161/jaha.124.039734 · Cited by 4
“55 This study was a prospective cohort analysis of the FOURIER and IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial) trials and included patients with PAD, although observations in this group were not specifically analyzed.”
Zhang, Y., Chai, Z., Chen, M., Li, S., Zhuang, W., Hu, W. W., & Chen, M. (2025) · Precision medicine and engineering. · doi:10.1016/j.preme.2025.100046 · Cited by 5
Improving Cardiovascular Risk Assessment to Optimize Therapy
Adolphe, A., Wilder, S., Duro, T., Eaton, R. P., & Schade, D. S. (2023) · World Journal of Cardiovascular Diseases · doi:10.4236/wjcd.2023.131002 · Cited by 4
Traditional and Novel Markers: Target of Treatment vs Marker of Risk
Mancini, G. B. J., Poirier, P., & Esau, D. (2024) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2024.04.003 · Cited by 4
“27,36,37 This distinction underscores why, in the speci fi c conditions mentioned previously, the sole guideline-recommended fi sh oil intervention is con fi ned to icosapent ethyl.”
InfluentialMovahedan, M., Ellis, U. M., & Barry, A. R. (2024) · American Journal of Cardiovascular Drugs · doi:10.1007/s40256-024-00682-0 · Cited by 4
“Further, ApoB may act as a better predictor of ASCVD events versus LDL-C or non-high-density lipoprotein cholesterol [28].”
Interplay of Atherogenic Particle Number and Particle Size and the Risk of Coronary Heart Disease
Pencina, K. M., Pencina, M. J., Lawler, P. R., Engert, J. C., Dufresne, L., Ridker, P. M., Thanassoulis, G., Mora, S., & Sniderman, A. D. (2022) · Clinical Chemistry · doi:10.1093/clinchem/hvac172 · Cited by 4
Triglyceride-rich lipoprotein cholesterol and cardiovascular risk
Bilgic, S., Remaley, A. T., & Sniderman, A. D. (2023) · Current Opinion in Lipidology · doi:10.1097/mol.0000000000000905 · Cited by 5
Gomes, D., Paiva, M. S., Freitas, P., Albuquerque, F., Lima, M. R., Santos, R. R., Presume, J., Trabulo, M., Aguíar, C., Ferreira, J., et al. (2024) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20230242 · Cited by 4
Zhai, Y., Fu, J. F., Yang, J., et al. (2025) · Frontiers in Pharmacology · doi:10.3389/fphar.2025.1583509 · Cited by 3
Nelson, J. R. (2025) · Cardiology Plus · doi:10.1097/cp9.0000000000000130 · Cited by 3
Genedy, N., & Zouwail, S. (2025) · Journal of clinical lipidology · doi:10.1016/j.jacl.2025.11.008 · Cited by 4
“2,3 The phenomenon of apoB/LDL-C discordance arises when these two biomarkers provide conflicting risk assessments.”
Lyu, L., Kao, C., Su, J., Yu, Y., Zhang, X., Lyu, J., Che, J., & Zhang, J. (2026) · Lipids in Health and Disease · doi:10.1186/s12944-025-02852-8 · Cited by 4
“Substantial evidence from observational and Mendelian randomization studies in the general population indicates that apoB is a superior predictor of ASCVD risk compared to LDL-C [11–13, 23, 24].”
Non-HDL Cholesterol and Apolipoprotein B Measures and Risk of Atherosclerotic Cardiovascular Disease
Johannesen, C. D. L., Langsted, A., Nordestgaard, B. G., & Mortensen, M. B. (2026) · JAMA Cardiology · doi:10.1001/jamacardio.2026.0898 · Cited by 4
Dyslipidemia paradox: Analysis from the veterans exercise testing study
Vainshelboim, B., & MYERS, J. N. (2023) · PLoS ONE · doi:10.1371/journal.pone.0287923 · Cited by 3
Zhao, S., Song, Y., Nakashima, Y., Zou, X., Koga, T., Ishida, T., Li, R., Hirota, Y., Tanaka, Y., & Ishii, Y. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26073363 · Cited by 3
“HDL-C and LDL-C play crucial roles in cholesterol metabolism and cardiovascular health [33].”
InfluentialVelilla, T. A., Guijarro, C., Ruíz, R. C., Piñero, M. R., Marcos, J. F. V., Pérez, A., López, M. A. B., López, A. M., Donaire, J. A. G., Obaya, J. C., et al. (2023) · Advances in Laboratory Medicine / Avances en Medicina de Laboratorio · doi:10.1515/almed-2023-0010 · Cited by 4
Chevalier, C., Oliveira, A. R., Blanchard, V., May, C. L., Cariou, B., Hadjadj, S., & Croyal, M. (2025) · Diabetes & Metabolism · doi:10.1016/j.diabet.2025.101683 · Cited by 4
Yu, X., Yuan, Y., Dong, X., Xier, Z., Ma, L., Peng, H., Li, G., & Yang, Y. (2025) · Annals of Medicine · doi:10.1080/07853890.2025.2529565 · Cited by 3
Apolipoprotein B versus non-high-density lipoprotein cholesterol: is the debate really over?
Bittner, V. (2022) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwac261 · Cited by 3
Ao, L., van Heemst, D., Luo, J. M., Teder‐Laving, M., Mägi, R., Frikke‐Schmidt, R., van Dijk, K. W., & Noordam, R. (2024) · GeroScience · doi:10.1007/s11357-024-01348-0 · Cited by 2
Levinson, S. S. (2024) · The Journal of Applied Laboratory Medicine · doi:10.1093/jalm/jfae125 · Cited by 2
Lu, Z., Wang, N., Yu, Q. P., et al. (2025) · Frontiers in Pharmacology · doi:10.3389/fphar.2025.1551833 · Cited by 2
PCSK9-Targeting Drugs and Gender: Are There Any Differences?
Liberati, V., Guidotti, G., Sorrentino, A., Slanzi, M., Lotti, E., Crudele, F., Rogolino, A. A., Alfano, F., Giusti, B., Gori, A. M., et al. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14134469 · Cited by 3
“LDL cholesterol (LDL-C) is one of the main modifiable cardiovascular risk (CV) factors, since the accumulation of LDL-C and other apo-B-containing lipoproteins is a key event in the initiation and progression of the atherosclerotic process [14,15].”
Shen, Q., Gu, G., Yang, D., & Zheng, Y. (2025) · Genes · doi:10.3390/genes16121398 · Cited by 3
“Atherosclerosis (AS), a chronic inflammatory disease of the arterial wall, is primarily driven by the accumulation of apolipoprotein B-containing lipoproteins in the subendothelial space [1,2].”
Ao, L., Noordam, R., Trompet, S., van Vliet, N. A., Sattar, N. A., Rodondi, N., Moutzouri, E., Atighetchi, S., Kearney, P. M., Quinn, T., et al. (2026) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgag155 · Cited by 2
Are we underestimating the benefits of lipid-lowering therapies?
Pirillo, A., Casula, M., Olmastroni, E., Scotti, S., Corsini, A., & Catapano, A. L. (2026) · Pharmacological Reviews · doi:10.1016/j.pharmr.2026.100140 · Cited by 2
ASCVD risk stratification using apolipoprotein B and the LDL-C to total cholesterol ratio
Wang, B., Nurmohamed, N. S., Kraaijenhof, J. M., & Li, D. (2026) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwag260 · Cited by 3
Bork, C., Nordestgaard, B. G., Hedegaard, B. S., Vrablik, M., Evans, E., Freiberger, T., Fras, Z., Nanchen, D., Sadiq, F., Ray, K. K., et al. (2026) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2026.120757 · Cited by 2
Self-citationApolipoprotein B and Lipid Profile among Patients Diagnosed with Acute Myocardial Infarction.
Shrestha, D., Yadav, B. K., Gajurel, R. M., Sharma, V. K., Raut, M., Bhattarai, A., Shrestha, S., Ghimire, S., Shakya, B., & Tuladhar, E. T. (2022) · Nepalese Heart Journal · doi:10.3126/njh.v19i1.45292 · Cited by 3
Apolipoprotein B: An essential cholesterol metric for atherosclerotic cardiovascular disease
Fischer, K., & Kassem, L. (2022) · American Journal of Health-System Pharmacy · doi:10.1093/ajhp/zxac287 · Cited by 2
Ding, M., Li, Q. F., Peng, T. H., Wang, T. Q., Yan, H. H., Tang, C., Wang, X. Y., Yin, G., & Zheng, L. (2022) · Aging · doi:10.18632/aging.204422 · Cited by 2
Bai, X., Zhang, W., & Yu, T. (2023) · Biomarkers in Medicine · doi:10.2217/bmm-2023-0507 · Cited by 2
Raab, H., Hauser, E. R., Kwee, L. C., Shah, S. H., Kraus, W. E., & Ward-Caviness, C. K. (2024) · Aging · doi:10.18632/aging.205758 · Cited by 3
“It is associated with insulin resistance [57] and myocardial infarction [58].”
Jaliliyan, A., Madankan, A., Mosavari, H., Khalili, P., Pouraskari, A. B., Lotfi, S., Honarfar, A., Fakhri, E., & Eghbali, F. (2024) · Obesity Surgery · doi:10.1007/s11695-024-07258-6 · Cited by 2
Wang, S., Gao, H., Zhang, M., et al. (2024) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmso.s465391 · Cited by 2
“27 Contrarily, as the main protein component of HDL, apo A1 not only participates in the reverse transport of cholesterol but also has anti-inflammatory and immunomodulatory effects.”
BackgroundImpact of risk factors on intervened and non-intervened coronary lesions
Sheng, X. (2024) · American Journal of Cardiovascular Disease · doi:10.62347/xtbg3549 · Cited by 2
Post, A., Links, M. H., Zandee, W. T., Connelly, M. A., Links, T. P., & Dullaart, R. P. F. (2025) · Lipids in Health and Disease · doi:10.1186/s12944-025-02561-2 · Cited by 2
“Moreover, the association of apoB with incident ASCVD is as strong or perhaps even stronger than that of LDL cholesterol [31, 32].”
Chen, C., Gu, Y., Xu, J., Xiao, Y., Wang, C., Chen, Y., Huang, H., Chen, Q., Chen, Y., Chen, Q., et al. (2025) · Scientific Reports · doi:10.1038/s41598-025-10502-3 · Cited by 2
“…a Trunk fat mass percentage and leg fat mass percentage were mutually adjusted for each other. the number of apoB particles matters more than the cholesterol they carry because it is the particle itself that enters and is the primary driver of this entrapment within the arterial wall 28 .”
van der Laarse, A., & Cobbaert, C. M. (2021) · Expert Review of Cardiovascular Therapy · doi:10.1080/14779072.2021.2022475 · Cited by 3
“containing lipoproteins should be the focus of therapeutic strategies [108].”
BackgroundBenam, S. P., Mirabdali, S., Ebrahimi, N., Daneshvar, M., Vahedi, S., Abbasifard, F., & Rounagh, M. (2024) · Prostaglandins & Other Lipid Mediators · doi:10.1016/j.prostaglandins.2024.106872 · Cited by 2
Ao, L., van Heemst, D., Jukema, J. W., Rensen, P. C. N., van Dijk, K. W., & Noordam, R. (2023) · medRxiv · doi:10.1101/2023.03.01.23286619 · Cited by 2
“These observational findings have been attributed to a reduction in apolipoprotein B (ApoB), which has been suggested as the primary marker for cardiovascular disease risk independent of lipid content (cholesterol or TG) and type of ApoB-containing lipoprotein (cholesterol-rich LDL or TG-rich VLDL) (4-7).”
BackgroundZhang, W., Wang, R., & Shi, F. (2024) · Clinical Neurology and Neurosurgery · doi:10.1016/j.clineuro.2024.108185 · Cited by 1
Ao, L., van Heemst, D., Jukema, J. W., Rensen, P. C. N., van Dijk, K. W., & Noordam, R. (2025) · Journal of Lipid Research · doi:10.1016/j.jlr.2025.100778 · Cited by 4
Hart, T. L., Kris‐Etherton, P. M., & Petersen, K. H. (2025) · Journal of Nutrition · doi:10.1016/j.tjnut.2025.03.014 · Cited by 1
“All apoB-containing lipoprotein particles are atherogenic because apoB-containing lipoprotein particles can cross the arterial endothelial cell layer and become trapped within the extracellular matrix of the intima in the arterial wall initiating atherosclerotic plaque development [26, 27].”
Wang, J., Liu, M., Zahid, R., et al. (2025) · Microchemical Journal · doi:10.1016/j.microc.2025.115124 · Cited by 1
Insulin resistance as potential mediator linking ApoB/ApoA1 to MAFLD, but not inflammation
Yang, M., Liu, X., Li, Q., et al. (2025) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/20420188251378318 · Cited by 1
Hanyu, W., Clarke, R., Kartsonaki, C., Millwood, I. Y., Walters, R., Hill, M., Avery, D., Yu, C., Sun, D.-Y., Lv, J., et al. (2025) · European Heart Journal Open · doi:10.1093/ehjopen/oeaf119 · Cited by 1
Fu, C., Gong, Y., Gao, X., Li, Y., Wang, G., Han, B., Liu, S., Zhang, H., He, D., Wang, F., et al. (2025) · BMC Gastroenterology · doi:10.1186/s12876-025-04130-4 · Cited by 1
“The ApoB/ApoA1 ratio represents the balance between pro-atherosclerotic and anti-atherosclerotic elements, serving as a more precise measure of the systemic lipid metabolism [22–25].”
Wan, A.-H., Han, Y., Wu, L., Wei, Y., Xiang, X., Chen, Y., Chen, J., Song, A., & Zhao, K. (2025) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2025.104474 · Cited by 2
Hou, Y., Zhang, X., Sun, X., Qin, Q., Jia, M., Su, X., & Chen, Y. (2026) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/atvbaha.125.324122 · Cited by 1
LL-37–ApoB-100 Complex Serves as a Biomarker of Coronary Artery Disease
Fang, Y., Zhang, Z., Cao, Q., Li, Y., Duan, Y., 邦猛, 平., Duan, Z., Gan, W., Gao, J., Hua, M., et al. (2026) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/atvbaha.125.323486 · Cited by 2
Extremera-García, M. J., Rojas-Torres, M., Priego, B., Beltrán-Camacho, L., Eslava-Alcón, S., Rodríguez-Martín, F. J., Benítez-Camacho, J., Ballesteros-Ribelles, A., Martínez‐Val, A., Olsen, J. V., et al. (2026) · Molecular Biomedicine · doi:10.1186/s43556-026-00438-z · Cited by 1
O-GlcNAcylation as a Metabolic Integrator in Cardiovascular Physiology and Disease
Malik, S. S., Pi, X., & Xie, L. (2026) · International Journal of Molecular Sciences · doi:10.3390/ijms27114662 · Cited by 1
“Atherosclerosis is a central pathological process underlying CHD and is a major contributor to global morbidity and mortality, including myocardial infarction, stroke, and peripheral artery disease [115].”
Metabolic syndrome is associated with accelerated brain aging
Dove, A. E., Wang, J., Yang, R., Sakakibara, S., Arvanitakis, Z., Schneider, A. L. C., Gottesman, R. F., & Xu, W. (2026) · Alzheimer s & Dementia · doi:10.1002/alz.71563 · Cited by 3
“…data on regional brain volumes from T1-weighted imaging to estimate brain age, our analysis integrated data from six MRI modalities: T2-FLAIR ApoB and the ApoB/ApoA1 ratio are markers of atherogenicity, 46,47 pointing to atherosclerosis as a potential mechanism connecting MetS andbrainaging.”
Lago‐Rodríguez, M., Sánchez, M. S., Torres, A., Díez, C., Fanciulli, C., Pérez, L., Tejerina, F., Bello-Martínez, E., Bellón, J. M., Muñóz, P., et al. (2026) · Clinical Medicine · doi:10.1016/j.clinme.2026.100625 · Cited by 1
“9 The negative impact of certain antiretroviral drugs on lipid profiles is well established.”
Comparison of the 2025 ESC/EAS and 2026 ACC/AHA guidelines for dyslipidaemia management
Finocchiaro, S., Mauro, M. S., Bordonaro, C., Bujak, K., Cosentino, C., Cutore, L., Leo, G. D., Nasisi, F., Redigolo, P., & Capodanno, D. (2026) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwag413 · Cited by 1
Arrobas, T., Guijarro, C., Campuzano, R., Piñero, M. R., Marcos, J. F. V., López, A. M. B., López, A. M., López, A. M., Donaire, J. A. G., Obaya, J. C., et al. (2023) · REC CardioClinics · doi:10.55783/rcmf.160106 · Cited by 8
Consensus document for lipid profile determination and reporting in Spanish clinical laboratories
Velilla, T. A., Guijarro, C., Ruíz, R. C., Piñero, M. R., Marcos, J. F. V., Pérez, A., López, M. A. B., López, A. M., Donaire, J. A. G., Obaya, J. C., et al. (2023) · Clínica e Investigación en Arteriosclerosis (English Edition) · doi:10.1016/j.artere.2023.05.001 · Cited by 1
“41 When direct determination of LDL cholesterol or Apo B is not available, non-HDL cholesterol can be used as an approximation.”
Consensus document for lipid profile testing and reporting in Spanish clinical laboratories
Velilla, T. A., Guijarro, C., Ruíz, R. C., Piñero, M. R., Marcos, J. F. V., Pérez, A., López, M. A. B., López, A. M., Donaire, J. A. G., Obaya, J. C., et al. (2023) · Revista Clínica Española (English Edition) · doi:10.1016/j.rceng.2023.06.001 · Cited by 1
Impact of serum apolipoproteins on the prognosis of acute ischemic stroke after thrombolysis
Zhang, W., Wang, R., & Shi, F. (2024) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2024.107944 · Cited by 1
Li, L., Chou, V. H. C., Chou, O. H. I., Roy, S., Chan, J. S. K., Wong, W. T., Liu, T., Lip, G. Y. H., Cheung, B. M. Y., Tse, G., et al. (2024) · medRxiv · doi:10.1101/2024.02.08.24302507 · Cited by 1
Systemic inflammation is a minor contributor to remnant cholesterol atherogenicityPreprint
Kraaijenhof, J. M., Kerkvliet, M., Nurmohamed, N. S., Grefhorst, A., Kroon, J., Wareham, N. J., Hovingh, G. K., Stroes, E. S. G., Boekholdt, S. M., & Reeskamp, L. F. (2024) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2024.07.18.604203 · Cited by 1
“(9–13) One explanation for our observation that remnant cholesterol is associated with ASCVD beyond apoB could lie in its inflammatory effects.”
BackgroundSelf-citationSniderman, A. D. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2024.07.033 · Cited by 1
Vastrad, B. M., Pattanashetti, S., & Vastrad, C. M. (2024) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2024.10.13.618070 · Cited by 1
Why Non-HDL Cholesterol is Preferred over Apolipoprotein B-100 (Apo B)Preprint
Levinson, S. S. (2023) · doi:10.32388/tulata
Comment on: LDL-C – when to calculate and when to measure?
Ryan, A., Rasheed, E., & Twomey, P. J. (2023) · Journal of Clinical Pathology · doi:10.1136/jcp-2023-208779
Velilla, T. A., Guijarro, C., Ruíz, R. C., Piñero, M. R., Marcos, J. F. V., Pérez, A., López, M. A. B., López, A. M., Donaire, J. A. G., Obaya, J. C., et al. (2023) · Hipertensión y Riesgo Vascular · doi:10.1016/j.hipert.2022.12.002
Metadata
- Authors
- Marston, N. A., Giugliano, R. P., Melloni, G. E. M., Park, J.-G., Morrill, V., Blazing, M. A., Ference, B., Stein, E., Stroes, E. S., Braunwald, E., Ellinor, P. T., Lubitz, S. A., Ruff, C. T., & Sabatine, M. S.
- Affiliations
- Brigham and Women's Hospital (US)
- Broad Institute (US)
- Duke University (US)
- University of Cambridge (GB)
- Metabolic and Atherosclerosis Research Center, Cincinnati, Ohio
- Amsterdam University Medical Centers (NL)
- Thrombolysis in Myocardial Infarction (TIMI) Study Group, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Corresponding author
- Marston, Nicholas A.
- ORCID
- Venue
- JAMA Cardiology
- Publisher
- American Medical Association (AMA)
- Published
- 2022-03-01
- Volume
- 7
- Issue
- 3
- Pages
- 250
- ISSN
- 2380-6583 (ISSN-L)
- PMC
- PMC8590731
- OpenAlex
- W3213895219
- Semantic Scholar
- a8dd33ed82854a233b2e5383c88457332240ec72
- Cited by
- 262
- References
- 23
- Citations by year
- 2026: 43 · 2025: 50 · 2024: 67 · 2023: 68 · 2022: 32
- FWCI
- 35.66
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA Cardiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Funders
- British Heart Foundation (CH/1996001/9454)
- Medical Research Council (MC_PC_17228)
- National Heart, Lung, and Blood Institute (K08HL153950)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Cholesterol and Lipid Metabolism
- Keywords
- apolipoprotein B, apoB-containing lipoproteins, myocardial infarction, atherosclerosis, non-HDL cholesterol, triglycerides, LDL cholesterol, VLDL, cardiovascular risk, statin therapy, primary prevention, lipid control, FOURIER trial, IMPROVE-IT trial, UK Biobank
- MeSH terms
- Apolipoproteins B, Cholesterol, Female, Humans, Lipoproteins, Cholesterol, LDL, Male, Myocardial Infarction, Prospective Studies, Cohort Studies, Atherosclerosis
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