Risk-weighted apolipoprotein B (apoB): a novel summary metric outperforming traditional lipid biomarkers in predicting coronary heart disease
Authors' conclusion
RW-apoB represents not only particle number but also accounts for the higher atherogenicity of TRL and Lp(a). It offers clinically meaningful improvements in CHD risk stratification.
Study context
- Population
- UK Biobank and three other large population cohorts
- Comparison
- RW-apoB vs measured apoB for coronary heart disease (CHD) risk prediction
- Outcome
- CHD risk prediction
Methodological detailsUK Biobank derivation, 3 other population cohorts
- UK Biobank derivation
- 3 other population cohorts
Performance
As reported in the abstract
Individuals up- or down-ranked by ≥10 percentiles vs ranking by measured apoB
52%
Further findings
CHD event rate by reclassification
- Top RW-apoB quintile with elevated TRL and Lp(a), about one-third misclassified as lower risk by apoB: CHD event rate
- 5.4%
- Top measured apoB quintile with low TRL and Lp(a), correctly down-ranked: CHD event rate
- 3.9%
Residual risk in statin-treated subjects
- RW-apoB potentially a better index of residual risk
Original publication
Risk-weighted apoB: a novel summary metric outperforming traditional lipid biomarkers in predicting coronary heart disease. Eur Heart J. Published 22 January 2026. doi:10.
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