Prevention & lipidsCohort study
Integration of apolipoprotein B into the SCORE2 framework: implications for cardiovascular risk prediction
- Prospective cohort study
Authors' conclusion
Apolipoprotein B exhibited a dose-response relationship with cardiovascular risk but had limited standalone predictive utility within the UK Biobank population. However, combining ApoB with SCORE2 thresholds improved the identification of low-risk individuals, suggesting a complementary role for ApoB in refining cardiovascular risk stratification.
Study context
- Population
- UK Biobank participants eligible for SCORE2 calculation
- Participants
- 448,303 participants
- Exposure
- SCORE2 with Apolipoprotein B (ApoB) vs SCORE2 alone
- Outcome
- Predictive accuracy for cardiovascular disease (CVD) events:
- Discrimination
- Calibration
- Net reclassification improvement
- Follow-up
- 10 years
Main finding
As reported in the abstract
Model performance of SCORE2 with ApoB
- Integration of ApoB into SCORE2 did not significantly improve discrimination, calibration or net reclassification improvement
Observational data: associations, not effects.
Further findings
| Outcome | Values | SHR (95% CI) | P value | |
|---|---|---|---|---|
| CVD events per 0.2 g/L increase in ApoB · non-CV death as competing risk | 1.13 (1.11–1.14) | P < 0.001 | ||
| 0.512Subdistribution hazard ratio (log scale) |
| Outcome | Values | Estimate | P value |
|---|---|---|---|
| ApoB threshold analysis for CVD (Youden's Index) | ApoB ≥1.18 g/L Optimal cutoff 1.18 g/L · AUC 0.54 · Sensitivity 32.4% · Specificity 74.4% | ||
| CVD incidence in low-risk individuals | Low ApoB (<1.18 g/L) and low SCORE2 (<5%) 232.51 per 100 000 person-years · Low risk by SCORE2 alone 253.69 per 100 000 person-years |
Original publication
Integration of apolipoprotein B into the SCORE2 framework: implications for cardiovascular risk prediction. Eur J Prev Cardiol. Published 29 January 2025. doi:10.1093/eurjpc/zwaf039
Summarised from the published abstract; every number is checked against it