What is the association between apolipoprotein B (apoB) and the risk of myocardial infarction (MI) in primary and secondary prevention patients, compared to other lipid parameters?

Study design: Retrospective cohort study using data from the UK Biobank database, FOURIER, and IMPROVE-IT trials.


  • Number of patients studied: 389,529 (primary prevention cohort) and 40,430 (secondary prevention patients)
  • Inclusion criteria: Patients from UK Biobank database without lipid-lowering therapy (primary prevention cohort); patients from FOURIER and IMPROVE-IT trials (secondary prevention patients)
  • Exclusion criteria: Patients with missing or incomplete data on lipid parameters or clinical risk factors

Primary Outcome

Risk of myocardial infarction (MI) associated with apolipoprotein B (apoB) levels


Conclusion:The study suggests that apolipoprotein B (apoB) is the primary driver of atherosclerosis and may be a better predictor of MI risk compared to other lipid parameters. The results support using apoB as the primary marker to assess cardiovascular risk due to apoB lipoproteins.

Marston, N., Navar, A. M., & Thanassoulis, G. (2021). Association of Apolipoprotein B with Risk of Myocardial Infarction in Primary and Secondary Prevention Populations: A Secondary Analysis of 2 Randomized Clinical Trials and a Cohort Study. JAMA Cardiology.