SynthesisEuropean journal of preventive cardiology2020
Association of lowering apolipoprotein B with cardiovascular outcomes across various lipid-lowering therapies: Systematic review and meta-analysis of trials.
Synthesis in European journal of preventive cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- Association of apolipoproteins and lipoprotein(a) with metabolic syndrome: a systematic review and meta-analysis.Lipids in health and disease · 2023Pooled it
- American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022Guideline
- Effects of Influenza Vaccine on Mortality and Cardiovascular Outcomes in Patients With Cardiovascular Disease: A Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2021Pooled it
- Pecan Intake Improves Lipoprotein Particle Concentrations Compared with Usual Intake in Adults at Increased Risk of Cardiometabolic Diseases: A Randomized Controlled Trial.The Journal of nutrition · 2025Trial
- Rethinking Lipid Burden and the Role of Non-LDL Biomarkers in Stroke Risk Stratification.Current atherosclerosis reports · 2026Review
- The Angiopoietin-like Protein (ANGPTL) Axis in Dyslipidemia: Mechanisms, Cardiovascular Risk, and Emerging Therapies.Current atherosclerosis reports · 2026Review
- Apolipoprotein B/A1 Ratio for Predicting Major Adverse Cardiovascular Events in Coronary Artery Disease: Development and Validation of a Nomogram.International journal of general medicine · 2026Article
- Recent advances in immunotherapy targeting CETP proteins for atherosclerosis prevention.Human vaccines & immunotherapeutics · 2025Review
- Article
- Validation of the role of apolipoproteins in coronary artery disease patients with impaired kidney function for prognosis: a prospective cohort study in China.Nutrition journal · 2025Article
- Changes in apolipoproteins following ingestion of a beverage deliveringFrontiers in nutrition · 2025Article
- Apolipoprotein B in the Risk Assessment, Diagnosis, and Treatment of Cardiometabolic Diseases.Cardiology and cardiovascular medicine · 2025Article
- Lipid Accumulation Product Is Predictive of Cardiovascular Hospitalizations among Patients with Stable Ischemic Heart Disease: Long-Term Follow-Up of the LAERTES Study.Journal of cardiovascular development and disease · 2024Article
- Review
- Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2022.Journal of atherosclerosis and thrombosis · 2024Article
- Genetic association of lipids and lipid-lowering drug target genes with Endometrial carcinoma: a drug target Mendelian randomization study.Frontiers in endocrinology · 2024Article
- Apolipoprotein B is associated with CT-angiographic progression beyond low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol in patients with coronary artery disease.Lipids in health and disease · 2023Article
- The AACE 2022 Guideline: An Academic Appraisal.TouchREVIEWS in endocrinology · 2023Article
- New Therapeutic Approaches to the Treatment of Dyslipidemia 2: LDL-C and Lp(a).Journal of lipid and atherosclerosis · 2023Review
- Pharmaco-invasive therapy: Early implementation of statins and proprotein convertase subtilisin/kexin type 9 inhibitors after acute coronary syndrome.Frontiers in cardiovascular medicine · 2022Review
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 2 countries.
Funding
Abstract
aimsThe effect of therapeutic lowering of apolipoprotein B (apoB) on mortality and major adverse cardiovascular events is uncertain. It is also unclear whether these potential effects vary by different lipid-lowering strategies.
methodsA total of 29 randomized controlled trials were selected using PubMed, Cochrane Library and EMBASE through 2018. We selected trials of therapies which ultimately clear apolipoprotein B particles by upregulating low-density lipoprotein receptor (LDL-R) expression (statins, ezetimibe, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, bile acid sequestrants) or therapies which reduce apolipoprotein B independent of LDL-R (cholesteryl ester transfer protein inhibitor, fibrates, niacin, omega-3 fatty acids) with sample size of ≥1000 patients and follow-up of ≥1 year. The meta-regression and meta-analyses were constructed using a random effects model.
resultsIn 332,912 patients, meta-regression analyses showed relative risks of 0.95 for all-cause mortality (95% confidence interval 0.92-0.99) and 0.93 (0.88-0.98) for cardiovascular mortality for every 10 mg/dL decrease in apolipoprotein B by all interventions combined. Reduction in all-cause mortality was limited to statins (0.92 (0.86-0.98)). For MACE, the relative risk per 10 mg/dL reduction in apolipoprotein B was 0.93 (0.90-0.97) for all therapies combined, with both statin (0.88 (0.83-0.93)) and non-statin therapies (0.96 (0.94-0.99)). which clear apolipoprotein B by upregulating LDL-R showing significant reductions; whereas interventions which lower apolipoprotein B independent of LDL-R did not demonstrate this effect (1.02 (0.81-1.30)).
conclusionWhile both statin and established non-statin therapies (PCSK9 inhibitor and ezetimibe) reduced cardiovascular risk per decrease in apolipoprotein B, interventions which reduce apolipoprotein B independently of LDL-R were not associated with cardiovascular benefit.
Indexed as
Identifiers
What Socratic holds
Registered trials
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 Socratic graph.