Evidence map›Paper›PMID 40386959›Full record

ArticleEuropean journal of clinical investigation2025

Concordance-discordance between apolipoprotein B and lipid biomarkers in predicting 20-year atherosclerotic cardiovascular disease risk: The ATTICA study (2002-2022).

Sofia-Panagiota Giannakopoulou, Smaragdi Antonopoulou, Fotios Barkas, Evangelos Liberopoulos, Christina Chrysohoou, Petros P Sfikakis, Christos Pitsavos, Costas Tsioufis, Demosthenes Panagiotakos

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of clinical investigation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Trial
  2. Review
  3. Article
  4. Article
  5. Review
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sofia-Panagiota GiannakopoulouDepartment of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece.
Smaragdi AntonopoulouDepartment of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece.
Fotios BarkasDepartment of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
Evangelos LiberopoulosFirst Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece.
Christina ChrysohoouFirst Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece.
Petros P SfikakisFirst Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece.
Christos PitsavosFirst Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece.
Costas TsioufisFirst Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece.
Demosthenes PanagiotakosDepartment of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece.ORCID https://orcid.org/0000-0001-8583-153X

Funding

Autism Speaks AS2003Hellenic Atherosclerosis Society HAS2003Hellenic Cardiological Society HCS2002
6 · The paper itself

Abstract

backgroundA strong correlation exists between low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and apolipoprotein B100 (apoB). However, evidence suggests that LDL-C and non-HDL-C may underestimate apoB, potentially obscuring residual cardiovascular risk. Furthermore, interactions between apoB and lipoprotein(a) are implicated in atherogenesis. This study sought to determine whether discordance between apoB, LDL-C, non-HDL-C, or lipoprotein(a) is associated with 20-year atherosclerotic cardiovascular disease (ASCVD) risk within a cohort of apparently healthy adults.

methodsA cohort of 3042 CVD-free adults residing in greater Athens, Greece, was recruited in 2002. A 20-year follow-up was conducted in 2022, comprising n = 2169 participants, of which n = 1988 had complete data for cardiovascular disease incidence. Discordance between biomarkers was defined based on recommended lipid thresholds. Cox proportional hazards models were used to assess the association between discordant/concordant biomarker pairs and 20-year ASCVD risk.

resultsApoB strongly correlated with LDL-C and non-HDL-C, though concordance was limited. Increased 20-year ASCVD cumulative incidence with elevated apoB levels, beyond LDL-C, non-HDL-C, and lipoprotein(a). Discordance analysis revealed that elevated apoB independently predicted increased 20-year ASCVD risk, regardless of non-HDL-C and lipoprotein(a). However, this effect was observed only on concomitantly elevated LDL-C levels. Incorporating apoB into the assessment of traditional modifiable risk factors elucidated part of the previously residual 20-year ASCVD risk, especially in individuals with elevated LDL-C, non-HDL-C, or lipoprotein(a) levels.

conclusionsApoB may be a superior biomarker for assessing long-term ASCVD risk, indicating that apoB-containing lipoprotein particle number, rather than cholesterol content, is a more robust predictor of ASCVD risk.

Indexed as

Apolipoprotein B-100Apolipoproteins BAtherosclerosisCardiovascular DiseasesCholesterol, LDLLipoprotein(a)AdultAgedBiomarkersCholesterol, HDLFemaleGreeceHumansIncidenceMaleMiddle AgedAPOB protein, humanApolipoprotein B-100Apolipoproteins BBiomarkersCholesterol, HDLCholesterol, LDLLipoprotein(a)apolipoprotein Batherosclerotic cardiovascular disease riskdiscordanceLDL‐Clipoprotein(a)non‐HDL‐C

Identifiers

PMID40386959
PMCPMC12434434

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.