Evidence map›Paper›PMID 41060429›Full record

ArticleClinical research in cardiology : official journal of the German Cardiac Society2026

Association of apolipoprotein B, excess apolipoprotein B and apoB/apoA1 ratio with 20-year atherosclerotic cardiovascular disease risk: the ATTICA study (2002-2022).

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

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Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Is the Commitment to LDL-C Eternal?Methodist DeBakey cardiovascular journal · 2026
    Review
  3. 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, 17676, Athens, Greece.
Christina ChrysohoouFirst Cardiology Clinic, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, 15772, Athens, Greece.
Smaragdi AntonopoulouDepartment of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676, Athens, Greece.
Fotios BarkasDepartment of Internal Medicine, School of Medicine, University of Ioannina, 45500, Ioannina, Greece.
Evangelos LiberopoulosFirst Department of Propaedeutic Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Laiko General Hospital, 15772, Athens, Greece.
Petros P SfikakisFirst Department of Propaedeutic Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Laiko General Hospital, 15772, Athens, Greece.
Christos PitsavosFirst Cardiology Clinic, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, 15772, Athens, Greece.
Costas TsioufisFirst Cardiology Clinic, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, 15772, Athens, Greece.
Demosthenes PanagiotakosDepartment of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676, Athens, Greece. dbpanag@hua.gr.ORCID http://orcid.org/0000-0001-8583-153X

Funding

Hellenic Atherosclerosis Society HAS2003Hellenic Society of Cardiology HCS2002
6 · The paper itself

Abstract

backgroundThis study investigated the relationship between apolipoprotein B (apoB), "excess apoB" (apoB beyond low-density lipoprotein cholesterol (LDL-C)), and apoB/apolipoprotein A1 (apoA1) ratio with 20-year atherosclerotic cardiovascular disease (ASCVD) incidence, using an age- and sex-specific approach.

methodsIn 2002, a cohort of 3042 adults, free of cardiovascular disease (CVD) residing in the greater Athens area (Greece) was recruited. A 20-year follow-up was conducted in 2022, comprising of 2169 participants, of whom 1988 had complete data for CVD incidence. Cox proportional hazards models were used to assess the association of apoB, excess apoB, and apoB/apoA1 with 20-year ASCVD risk and residual risk (events not predicted by standard factors).

resultsOlder participants and males had higher levels of apoB, excess apoB, and apoB/apoA1. In the overall cohort, only apoB was significantly associated with ASCVD risk (hazard ratio (HR), 1.006; p = 0.003). However, age- and sex-dependent associations were observed as apoB, excess apoB, and apoB/apoA1 significantly predicted increased ASCVD incidence only in males under 40 years (HR 1.025, p = 0.005; 1.052, p = 0.003; 1.396, p = 0.002; respectively). Significant associations were observed with residual ASCVD risk in the overall cohort, with the most pronounced associations seen in males under 40 (HR 1.023, p = 0.001; 1.039, p < 0.001; 1.285, p = 0.002; respectively).

conclusionsThe association of apoB, excess apoB, and apoB/apoA1 with long-term ASCVD incidence and residual risk demonstrates age- and sex-dependent variations, with younger males showing elevated risk, highlighting the value of these markers beyond traditional risk factors and emphasizing the need for age- and sex-specific considerations in ASCVD risk assessment.

Indexed as

Apolipoprotein A-IApolipoprotein B-100Apolipoproteins BAtherosclerosisAdultAgedAge FactorsBiomarkersFemaleFollow-Up StudiesGreeceHumansIncidenceMaleMiddle AgedRisk AssessmentAPOA1 protein, humanAPOB protein, humanApolipoprotein A-IApolipoprotein B-100Apolipoproteins BBiomarkersApoB/ApoA1 ratioApolipoprotein BAtherosclerotic cardiovascular disease riskExcess apolipoprotein BResidual risk

Identifiers

PMID41060429

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Registered trials

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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.