ApoB vs. LDL

Are elevated apoB and/or non-HDL cholesterol superior to elevated LDL cholesterol in identifying statin-treated patients at residual risk of all-cause mortality and myocardial infarction?

Study design: Observational cohort study

Population

Number of patients studied: 13,015
Inclusion criteria: Statin-treated patients from the Copenhagen General Population Study- 13,015 individuals age 20-100 with self-reported statin use
Exclusion criteria: None mentioned explicitly

Interventions: Not applicable (observational study)

Primary outcome: Residual risk of all-cause mortality and myocardial infarction in relation to apoB, non-HDL cholesterol, and LDL cholesterol

Conclusion

In statin-treated patients, elevated apoB and non-HDL cholesterol, but not LDL cholesterol, are associated with residual risk of all-cause mortality and myocardial infarction.

Discordance analysis demonstrates that apoB is a more accurate marker of all-cause mortality risk in statin-treated patients than LDL cholesterol or non-HDL cholesterol, and apoB in addition is a more accurate marker of risk of myocardial infarction than LDL cholesterol.