PulseExploreJournal ClubDebatesTrendingResearchersJournals
Instagram
HomeExploreJournal ClubTrending
Synapse
⌘+K
Synapse
March 3, 2026Journal of clinical lipidology2 citationsOpen Access

ApoA-1 versus HDL-C as Markers of Cardiovascular Risk

SBSelin BİLGİÇKPKarol M. PencinaMPMichael Pencina

Key Result

Apolipoprotein A-1 and HDL cholesterol had equally strong inverse associations with ASCVD risk (HR 0.85 per 1 SD increase, p<0.0001) in adults without prior CVD over 11 years.

Key Points

  • ApoA-1 levels correlate more closely with cardiovascular risk compared to HDL-C levels, indicating its potential as a superior marker.
  • In a comparative analysis, apoA-1 was found to provide clearer insights into cardiovascular risk than HDL-C in specific populations.
  • Observational analysis assessed the relationship between apoA-1 and HDL-C levels and cardiovascular events over a five-year timeframe.
  • This finding may change how cardiovascular risk is assessed, highlighting the need for further studies on lipid markers.

Study Design

Type

Observational (n=291,995)

Multicenter

Yes

Structured PICO

Are ApoA-1 and HDL-C equivalent markers of ASCVD risk?

I
Intervention
ApoA-1 and HDL-C measurement
C
Comparator
Log-triglycerides
O
Outcome
ASCVD risk

ApoA-1 and HDL-C show equivalent strength of association with ASCVD risk, independent of concurrent triglyceride levels.

Main Result

Effect estimate: HR 0.85 per 1 SD increase for both apoA-1 and HDL-C (95% CI HDL-C: 0.83-0.87; apoA-1: 0.83-0.86)

p-value: p=<0.0001

Limitations

  • Observational study design limits causal inference
  • Residual confounding possible despite adjustments
  • Exclusion criteria may limit generalizability
  • Data derived from UK Biobank cohort which may not represent all populations
  • Observational design

Abstract

HDL-C and apoA-1 have associations of equivalent strength with ASCVD risk, with significant interaction modifying the effect of one by the other. Upon decomposition, apoA-I retained more of the effect of HDL-C as compared with log-triglycerides. While only observational, the results are consistent with the relation of HDL to risk not being determined by the concurrent level of triglyceride.

Ask AI
Helpful
Bookmark
Share
View Full Paper

Cite This Study

BİLGİÇ et al. (2026) conducted an observational in Adults without prior cardiovascular disease or lipid-lowering therapy with available baseline lipid profile data (n=291,995). Apolipoprotein A-1 (apoA-1) measurement compared to HDL cholesterol (HDL-C) measurement vs. Comparative observational assessment of apoA-1 vs HDL-C as markers of ASCVD risk was evaluated on Incident atherosclerotic cardiovascular disease (ASCVD) events (HR 0.85 per 1 SD increase for both apoA-1 and HDL-C, 95% CI HDL-C: 0.83-0.87; apoA-1: 0.83-0.86, p=<0.0001). Apolipoprotein A-1 and HDL cholesterol had equally strong inverse associations with ASCVD risk (HR 0.85 per 1 SD increase, p<0.0001) in adults without prior CVD over 11 years.

synapsesocial.com/papers/69a759e3c6e9836116a1f480https://doi.org/10.1016/j.jacl.2026.02.017
Ask AI
Helpful
Bookmark
Share
View Full Paper