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Excess Apolipoprotein B and Cardiovascular Risk in Women and Men

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Title: Excess Apolipoprotein B and Cardiovascular Risk in Women and Men
Authors: Camilla Ditlev Lindhardt Johannesen, Anne Langsted, Børge Grønne Nordestgaard, Martin Bødtker Mortensen
Source: Johannesen, C D L, Langsted, A, Nordestgaard, B G & Mortensen, M B 2024, 'Excess Apolipoprotein B and Cardiovascular Risk in Women and Men', Journal of the American College of Cardiology, vol. 83, no. 23, pp. 2262-2273. https://doi.org/10.1016/j.jacc.2024.03.423
Publisher Information: Elsevier BV, 2024.
Publication Year: 2024
Subject Terms: cardiovascular risk, Male, Adult, Atherosclerosis/blood, Denmark, Myocardial Infarction, Cardiovascular Diseases/blood, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Myocardial Infarction/epidemiology, apolipoprotein B, Humans, Apolipoproteins B, Aged, Cholesterol, LDL, Middle Aged, Atherosclerosis, Denmark/epidemiology, 3. Good health, Apolipoproteins B/blood, Cholesterol, LDL/blood, Cardiovascular Diseases, Heart Disease Risk Factors, LDL cholesterol, Female, atherosclerosis, Follow-Up Studies
Description: Low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apoB) are highly correlated measures of atherogenic lipoproteins.The study investigators hypothesized that excess apoB is associated with an increased risk of myocardial infarction (MI), atherosclerotic cardiovascular disease (ASCVD), and all-cause mortality.The study included 53,484 women and 41,624 men not taking statins from the Copenhagen General Population Study. Associations of excess apoB with the risk of MI, ASCVD, and all-cause mortality were estimated by Cox proportional hazards regressions with 95% CIs. Excess apoB was defined as measured levels of apoB minus expected levels of apoB from LDL-C alone; expected levels were defined by linear regressions of LDL-C levels vs apoB levels in individuals with triglycerides ≤1 mmol/L (89 mg/dL).During a median follow-up of 9.6 years, 2,048 MIs, 4,282 ASCVD events, and 8,873 deaths occurred. There was a dose-dependent association between excess apoB and the risk of MI and ASCVD in both women and men, as well as an association with the risk of all-cause mortality in women. For ASCVD in women compared with those with excess apoB 100 mg/dL. Corresponding HRs in men were 1.14 (95% CI: 1.02-1.26), 1.41 (95% CI: 1.26-1.57), 1.41 (95% CI: 1.25-1.60), and 1.52 (95% CI: 1.13-2.05), respectively. Results were robust across the entire LDL-C spectrum.Excess apoB (ie, the value of apoB above that contributed by LDL-C levels alone) is associated dose-dependently with an increased risk of MI and ASCVD in women and men. This finding demonstrates that apoB provides important predictive value beyond LDL-C across the entire LDL-C spectrum.
Document Type: Article
Language: English
ISSN: 0735-1097
DOI: 10.1016/j.jacc.2024.03.423
Access URL: https://pubmed.ncbi.nlm.nih.gov/38839200
http://www.scopus.com/inward/record.url?scp=85194045154&partnerID=8YFLogxK
https://doi.org/10.1016/j.jacc.2024.03.423
https://pure.au.dk/portal/en/publications/7c53993a-1072-4f86-bd74-636819f40028
Rights: Elsevier Non-Commercial
Accession Number: edsair.doi.dedup.....a0a2bdf1ba97135c1ff11a6e05663f58
Database: OpenAIRE
Description
Abstract:Low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apoB) are highly correlated measures of atherogenic lipoproteins.The study investigators hypothesized that excess apoB is associated with an increased risk of myocardial infarction (MI), atherosclerotic cardiovascular disease (ASCVD), and all-cause mortality.The study included 53,484 women and 41,624 men not taking statins from the Copenhagen General Population Study. Associations of excess apoB with the risk of MI, ASCVD, and all-cause mortality were estimated by Cox proportional hazards regressions with 95% CIs. Excess apoB was defined as measured levels of apoB minus expected levels of apoB from LDL-C alone; expected levels were defined by linear regressions of LDL-C levels vs apoB levels in individuals with triglycerides ≤1 mmol/L (89 mg/dL).During a median follow-up of 9.6 years, 2,048 MIs, 4,282 ASCVD events, and 8,873 deaths occurred. There was a dose-dependent association between excess apoB and the risk of MI and ASCVD in both women and men, as well as an association with the risk of all-cause mortality in women. For ASCVD in women compared with those with excess apoB 100 mg/dL. Corresponding HRs in men were 1.14 (95% CI: 1.02-1.26), 1.41 (95% CI: 1.26-1.57), 1.41 (95% CI: 1.25-1.60), and 1.52 (95% CI: 1.13-2.05), respectively. Results were robust across the entire LDL-C spectrum.Excess apoB (ie, the value of apoB above that contributed by LDL-C levels alone) is associated dose-dependently with an increased risk of MI and ASCVD in women and men. This finding demonstrates that apoB provides important predictive value beyond LDL-C across the entire LDL-C spectrum.
ISSN:07351097
DOI:10.1016/j.jacc.2024.03.423