Evidence mapPaperPMID 41568673Full record

ArticleEuropean heart journal2026

Risk-weighted apoB: a novel summary metric outperforming traditional lipid biomarkers in predicting coronary heart disease.

Michaela B Rehman, Elias Björnson, Martin Adiels, Jakub Morze, Göran Bergström, Anders Gummesson, David Erlinge, Tove Fall, Ljubica Matic, Stefan Söderberg and 3 more

Abstract read
In one paragraph

Article in European heart journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

13 authors.

Michaela B RehmanCardiology Department, Ramsay Santé, Médipôle Lyon-Villeurbanne, Villeurbanne, France.ORCID 0009-0004-3053-6612
Elias BjörnsonInstitute of Medicine, University of Gothenburg, Gothenburg, Sweden.ORCID 0000-0002-0003-6463
Martin AdielsInstitute of Medicine, University of Gothenburg, Gothenburg, Sweden.ORCID 0000-0002-3667-589X
Jakub MorzeInstitute of Medicine, University of Gothenburg, Gothenburg, Sweden.ORCID 0000-0002-7119-0273
Göran BergströmInstitute of Medicine, University of Gothenburg, Gothenburg, Sweden.ORCID 0000-0003-4289-5722
Anders GummessonInstitute of Medicine, University of Gothenburg, Gothenburg, Sweden.
David ErlingeDepartment of Cardiology, Clinical Sciences, Lund University, Lund, Sweden.
Tove FallDepartment of Medical Sciences, Molecular Epidemiology, Uppsala University, Uppsala, Sweden.ORCID 0000-0003-2071-5866
Ljubica MaticDepartment of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.ORCID 0000-0002-7294-9667
Stefan SöderbergDepartment of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Carl Johan ÖstgrenCenter for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.
Chris J PackardInstitute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.ORCID 0000-0002-2386-9927
Jan BorénInstitute of Medicine, University of Gothenburg, Gothenburg, Sweden.ORCID 0000-0003-0786-8091

Funding

ALFagreement ALFGBG-965404Swedish governmentSwedish Heart Lung FoundationSwedish Research Council
6 · The paper itself

Abstract

BACKGROUND AND

aimsLDL-C and non-HDL-C do not fully capture coronary heart disease (CHD) risk attributed to all apoB-containing lipoproteins. Use of apolipoprotein B (apoB) as a marker of total atherogenic particle number improves risk prediction, but risk may still be underestimated when triglyceride-rich lipoproteins (TRL/remnants) and lipoprotein(a) [Lp(a)] are elevated. The aim was to formulate a new metric-risk-weighted apoB (RW-apoB)-designed to capture risk from LDL, TRL/remnants, and Lp(a) in a single number.

methodsBased on previously published estimates of the relative atherogenicity of LDL, TRL/remnant, and Lp(a) particles, RW-apoB was developed (using UK Biobank data) as an atherogenicity-weighted apoB-sum calculated as: RW-apoB = 11.65×TG(mmol/L) + 0.215×lipoprotein(a)(nmol/L) + 0.736×apoB(mg/dL).

resultsAssigning RW-apoB to individuals substantially reclassified their risk status. Compared with ranking by measured apoB, 52% of individuals were up- or down-ranked by ≥10 percentiles. About one-third of those in the top RW-apoB quintile-with elevated TRL and Lp(a) and a CHD event rate of 5.4%-were misclassified as lower risk by apoB. Conversely, individuals in the top measured apoB quintile but with low TRL and Lp(a) had a lower event rate (3.9%) and were correctly down-ranked. RW-apoB improved risk prediction, significantly increasing Harrell's C-index relative to apoB (P < .0001). In statin-treated subjects, RW-apoB was potentially a better index of residual risk. RW-apoB consistently outperformed apoB as a risk predictor in Cox models across the UK Biobank and three other large population cohorts.

conclusionsRW-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.

Indexed as

Apolipoproteins BCoronary DiseaseAgedBiomarkersCholesterol, LDLFemaleHumansLipoprotein(a)MaleMiddle AgedRisk AssessmentTriglyceridesApolipoproteins BBiomarkersCholesterol, LDLLipoprotein(a)TriglyceridesapoBCardiovascular diseaseLDLLDL cholesterolLp(a)Mendelian randomizationUK Biobank

Identifiers

PMID41568673
PMCPMC13337224

What Socratic holds

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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 Socratic graph.