Prevention & lipidsCohort study
Atherosclerotic cardiovascular disease (ASCVD) risk stratification using apolipoprotein B and the low-density lipoprotein cholesterol (LDL-C) to total cholesterol ratio
- Prospective cohort study
- six US cohorts
- prespecified subgroup analyses
Authors' conclusion
LDL-related atherogenic risk is more coherently explained by a dual-axis framework integrating ApoB-defined particle burden with LDL cholesterol composition captured by the LDL-C/TC ratio.
Study context
- Population
- Adults without CVD or lipid-lowering therapy at baseline, six US cohortsARIC
- Participants
- 9,238 adults
- Exposure
- ApoB/LDL-C-to-TC ratio phenotypes
- Outcome
- Incident ASCVD
- Follow-up
- Median 25.6 years
Main finding
As reported in the abstract
HR
- Dual-elevated
- 1.67
- Low-ApoB/high-ratio
- 1.28
Observational data: associations, not effects.
Further findings
Per-SD association with ASCVD (stronger than LDL-C)
- ApoB, adjusted HR per SD
- 1.20
- Martin/Hopkins LDL-C/TC ratio, adjusted HR per SD
- 1.27
Original publication
ASCVD risk stratification using apolipoprotein B and the LDL-C to total cholesterol ratio. Eur J Prev Cardiol. Published 9 May 2026. doi:10.1093/eurjpc/zwag260
Summarised from the published abstract; every number is checked against it