Excess Apolipoprotein B and Cardiovascular Risk in Women and Men.
J Am Coll Cardiol
; 83(23): 2262-2273, 2024 Jun 11.
Article
em En
| MEDLINE
| ID: mdl-38839200
ABSTRACT
BACKGROUND:
Low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apoB) are highly correlated measures of atherogenic lipoproteins.OBJECTIVES:
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.METHODS:
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).RESULTS:
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 <11 mg/dL, the multivariable adjusted HR was 1.08 (95% CI 0.97-1.21) for excess apoB 11 to 25 mg/dL, 1.30 (95% CI 1.14-1.48) for 26 to 45 mg/dL, 1.34 (95% CI 1.14-1.58) for 46 to 100 mg/dL, and 1.75 (95% CI 1.08-2.83) for 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.CONCLUSIONS:
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.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Apolipoproteínas B
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
J Am Coll Cardiol
Ano de publicação:
2024
Tipo de documento:
Article