{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T15:18:49Z","timestamp":1783523929526,"version":"3.55.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,20]],"date-time":"2022-04-20T00:00:00Z","timestamp":1650412800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Low-density lipoprotein cholesterol (LDL-C) is the primary target of lipid-lowering therapy on the management of hypercholesterolemia in the United States and European guidelines, while apolipoprotein B (apoB) is the secondary target. The objective was to determine if elevated levels of apoB is superior to LDL-C in assessing residual risk of coronary atherosclerotic heart disease and severity of coronary atherosclerosis in participants with statin treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included 131 participants with statin treatment. The generalized linear model and relative risk regression (generalized linear Poisson model with robust error variance) were used to analyze the association of the levels of apoB and LDL-C with the severity of coronary atherosclerosis and residual risk of coronary atherosclerotic heart disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Categorizing apoB and LDL-C based on tertiles, higher levels of apoB were significantly associated with the severity of coronary atherosclerosis (<jats:italic>P<\/jats:italic><jats:sub>trend<\/jats:sub> = 0.012), whereas no such associations were found for elevated levels of LDL-C (<jats:italic>P<\/jats:italic><jats:sub>trend<\/jats:sub> = 0.585). After multivariate adjustment, higher levels of apoB were significantly associated with residual risk of coronary atherosclerotic heart disease. When compared with low-level apoB (\u22640.66 g\/L), the multivariate adjusted RR and 95% CI of intermediate-level apoB (0.67\u20130.89 g\/L) and high-level apoB (\u22650.90 g\/L) were 1.16 (1.01, 1.33) and 1.31 (1.08, 1.60), respectively (<jats:italic>P<\/jats:italic><jats:sub>trend<\/jats:sub> = 0.011). There was a 45% increased residual risk of coronary atherosclerotic heart disease per unit increment in natural log-transformed apoB (<jats:italic>P<\/jats:italic><jats:sub>trend<\/jats:sub> &amp;lt;0.05). However, higher levels of LDL-C were not significantly associated with residual risk of coronary atherosclerotic heart disease. When compared with low-level LDL-C (\u22641.56 mmol\/L), the multivariate adjusted RR and 95% CI of intermediate-level LDL-C (1.57\u20132.30 mmol\/L) and high-level LDL-C (\u22652.31 mmol\/L) were 0.99 (0.84, 1.15) and 1.10 (0.86, 1.42), respectively (<jats:italic>P<\/jats:italic><jats:sub>trend<\/jats:sub> = 0.437). Similar results were observed in the stratified analyses and sensitivity analyses. No significant interactions were detected for both apoB and LDL-C (all <jats:italic>P<\/jats:italic><jats:sub>interaction<\/jats:sub><jats:italic>&amp;gt;<\/jats:italic>0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Elevated apoB are superior in assessing the residual risk of coronary atherosclerotic heart disease and severity of coronary atherosclerosis in participants with statin treatment.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2022.865863","type":"journal-article","created":{"date-parts":[[2022,4,20]],"date-time":"2022-04-20T11:59:23Z","timestamp":1650455963000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Residual Risk of Coronary Atherosclerotic Heart Disease and Severity of Coronary Atherosclerosis Assessed by ApoB and LDL-C in Participants With Statin Treatment: A Retrospective Cohort Study"],"prefix":"10.3389","volume":"13","author":[{"given":"Tianci","family":"Yao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weilin","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinshan","family":"Ke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofang","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bei","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinmei","family":"Ke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengyun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1161\/circoutcomes.109.910711","article-title":"Future Cardiovascular Disease in China: Markov Model and Risk Factor Scenario Projections From the Coronary Heart Disease Policy Model-China","volume":"3","author":"Moran","year":"2010","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(05)67394-1","article-title":"Efficacy and Safety of Cholesterol-Lowering Treatment: Prospective Meta-Analysis of Data From 90,056 Participants in 14 Randomised Trials of Statins","volume":"366","author":"Baigent","year":"2005","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000000625","article-title":"AHA\/ACC\/AACVPR\/AAPA\/ABC\/ACPM\/ADA\/AGS\/APhA\/ASPC\/NLA\/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"139","author":"Grundy","year":"2019","journal-title":"Circulation"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz455","article-title":"ESC\/EAS Guidelines for the Management of Dyslipidaemias: Lipid Modification to Reduce Cardiovascular Risk","volume":"41","author":"Mach","year":"2019","journal-title":"Eur Heart J"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(10)61350-5","article-title":"Efficacy and Safety of More Intensive Lowering of LDL Cholesterol: A Meta-Analysis of Data From 170,000 Participants in 26 Randomised Trials","volume":"376","author":"Baigent","year":"2010","journal-title":"Lancet"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1615664","article-title":"Evolocumab and Clinical Outcomes in Patients With Cardiovascular Disease","volume":"376","author":"Sabatine","year":"2017","journal-title":"N Engl J Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1410489","article-title":"Ezetimibe Added to Statin Therapy After Acute Coronary Syndromes","volume":"372","author":"Cannon","year":"2015","journal-title":"N Engl J Med"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/hvaa252","article-title":"Residual Cardiovascular Risk at Low LDL: Remnants, Lipoprotein(a), and Inflammation","volume":"67","author":"Hoogeveen","year":"2021","journal-title":"Clin Chem"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.2337\/db16-0046","article-title":"Pharmacological Targeting of the Atherogenic Dyslipidemia Complex: The Next Frontier in CVD Prevention Beyond Lowering LDL Cholesterol","volume":"65","author":"Xiao","year":"2016","journal-title":"Diabetes"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2019.3780","article-title":"Apolipoprotein B Particles and Cardiovascular Disease: A Narrative Review","volume":"4","author":"Sniderman","year":"2019","journal-title":"JAMA Cardiol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2006.01616.x","article-title":"Apo B Versus Cholesterol in Estimating Cardiovascular Risk and in Guiding Therapy: Report of the Thirty-Person\/Ten-Country Panel","volume":"259","author":"Barter","year":"2006","journal-title":"J\u00a0Intern Med"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1038\/35025203","article-title":"Atherosclerosis","volume":"407","author":"Lusis","year":"2000","journal-title":"Nature"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1097\/mol.0000000000000330","article-title":"The Central Role of Arterial Retention of Cholesterol-Rich Apolipoprotein-B-Containing Lipoproteins in the Pathogenesis of Atherosclerosis: A Triumph of Simplicity","volume":"27","author":"Bor\u00e9n","year":"2016","journal-title":"Curr Opin Lipidol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.01.027","article-title":"Apolipoprotein B and Non-HDL Cholesterol Better Reflect Residual Risk Than LDL Cholesterol in Statin-Treated Patients","volume":"77","author":"Johannesen","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"182","DOI":"10.11909\/j.issn.1671-5411.2019.03.014","article-title":"2018 Chinese Guidelines for Prevention and Treatment of Hypertension-A Report of the Revision Committee of Chinese Guidelines for Prevention and Treatment of Hypertension","volume":"16","year":"2019","journal-title":"J Geriatr Cardiol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"S15","DOI":"10.2337\/dc21-S002","article-title":"Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2021","volume":"44","year":"2021","journal-title":"Diabetes Care"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.11.025","article-title":"Predictive Value of the Residual SYNTAX Score in Patients With Cardiogenic Shock","volume":"77","author":"Barth\u00e9l\u00e9my","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(19)31997-x","article-title":"Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Three-Vessel or Left Main Coronary Artery Disease: 10-Year Follow-Up of the Multicentre Randomised Controlled SYNTAX Trial","volume":"394","author":"Thuijs","year":"2019","journal-title":"Lancet"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-09-048868","article-title":"The SYNTAX Score: An Angiographic Tool Grading the Complexity of Coronary Artery Disease","volume":"1","author":"Sianos","year":"2005","journal-title":"EuroIntervention"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A New Equation to Estimate Glomerular Filtration Rate","volume":"150","author":"Levey","year":"2009","journal-title":"Ann Intern Med"},{"key":"B21","doi-asserted-by":"crossref","DOI":"10.1007\/978-90-368-0980-1","volume-title":"ApoB in Clinical Care","author":"De Graaf","year":"2015"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.119.042134","article-title":"Cholesterol Insights and Controversies From the UK Biobank Study","volume":"140","author":"Mora","year":"2019","journal-title":"Circulation"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacl.2015.05.003","article-title":"Residual Dyslipidemia According to Low-Density Lipoprotein Cholesterol, Non-High-Density Lipoprotein Cholesterol, and Apolipoprotein B Among Statin-Treated US Adults: National Health and Nutrition Examination Survey 2009-2010","volume":"9","author":"Wong","year":"2015","journal-title":"J Clin Lipidol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.jacl.2007.12.006","article-title":"Differential Response of Cholesterol and Particle Measures of Atherogenic Lipoproteins to LDL-Lowering Therapy: Implications for Clinical Practice","volume":"2","author":"Sniderman","year":"2008","journal-title":"J Clin Lipidol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/s0735-1097(00)00918-9","article-title":"Apolipoprotein E Genotypes and Response of Plasma Lipids and Progression-Regression of Coronary Atherosclerosis to Lipid-Lowering Drug Therapy","volume":"36","author":"Ballantyne","year":"2000","journal-title":"J\u00a0Am Coll Cardiol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.107.713438","article-title":"Lipids, Apolipoproteins, and Their Ratios in Relation to Cardiovascular Events With Statin Treatment","volume":"117","author":"Kastelein","year":"2008","journal-title":"Circulation"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.11467","article-title":"Association of Genetic Variants Related to CETP Inhibitors and Statins With Lipoprotein Levels and Cardiovascular Risk","volume":"318","author":"Ference","year":"2017","journal-title":"JAMA"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.20045","article-title":"Association of Triglyceride-Lowering LPL Variants and LDL-C-Lowering LDLR Variants With Risk of Coronary Heart Disease","volume":"321","author":"Ference","year":"2019","journal-title":"Jama"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1080\/1354750x.2018.1474256","article-title":"Low-Density Lipoprotein-Associated Variables and the Severity of Coronary Artery Disease: An Untreated Chinese Cohort Study","volume":"23","author":"Zhao","year":"2018","journal-title":"Biomarkers"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.71.5.881","article-title":"Lipoprotein Predictors of the Severity of Coronary Artery Disease in Men and Women","volume":"71","author":"Reardon","year":"1985","journal-title":"Circulation"},{"key":"B31","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1038\/s41598-017-00499-9","article-title":"Novel and Traditional Lipid-Related Biomarkers and Their Combinations in Predicting Coronary Severity","volume":"7","author":"Li","year":"2017","journal-title":"Sci Rep"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1177\/0003319717712118","article-title":"The Comparison of Angiographic Scoring Systems With the Predictors of Atherosclerosis","volume":"69","author":"Kalkan","year":"2018","journal-title":"Angiology"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1161\/hc3501.095214","article-title":"Coronary Heart Disease Prediction From Lipoprotein Cholesterol Levels, Triglycerides, Lipoprotein(a), Apolipoproteins A-I and B, and HDL Density Subfractions: The Atherosclerosis Risk in Communities (ARIC) Study","volume":"104","author":"Sharrett","year":"2001","journal-title":"Circulation"},{"key":"B34","first-page":"5a","article-title":"Cholesterol and Lipids in the Risk of Coronary Artery Disease\u2013the Framingham Heart Study","author":"Castelli","year":"1988","journal-title":"Can J Cardiol"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.55.5.767","article-title":"HDL Cholesterol and Other Lipids in Coronary Heart Disease. The Cooperative Lipoprotein Phenotyping Study","volume":"55","author":"Castelli","year":"1977","journal-title":"Circulation"},{"key":"B36","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1016\/j.jacc.2016.11.042","article-title":"A Test in Context: Lipoprotein(a): Diagnosis, Prognosis, Controversies, and Emerging Therapies","volume":"69","author":"Tsimikas","year":"2017","journal-title":"J Am Coll Cardiol"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.865863\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,28]],"date-time":"2022-04-28T16:04:10Z","timestamp":1651161850000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.865863\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,20]]},"references-count":36,"alternative-id":["10.3389\/fendo.2022.865863"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2022.865863","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,20]]},"article-number":"865863"}}