title: Elevated ApoB serum levels strongly predict early cardiovascular events.
abstract: OBJECTIVE
  ApoB exerts a pro-thrombotic and pro-atherogenic effect and promotes the progression of atherosclerotic lesions. In the present study, we investigated if elevated ApoB serum levels predicted the risk of premature cardiovascular events in a prospective Swedish cohort study of 60-year-old men and women from Stockholm.
  
  
  METHODS
  A cohort consisting of every third man and woman turning 60 years of age in the large Stockholm area during the years 1997-1998 (n=4232).
  
  
  METHODS
  Incident cases of cardiovascular diseases have been recorded yearly by matching national registries. Exposure to high ApoB serum levels (≥0.9 g/l) was used to calculate the risk of cardiovascular diseases, and the time to the first cardiovascular event using Cox regression and Laplace regression, respectively.
  
  
  RESULTS
  Individuals exposed to high ApoB serum levels showed an increased risk of cardiovascular diseases over the 11 years of follow-up. The HR decreased over time from 2.49 at 4 years of study entry (95% CI 1.31 to 4.69) to 1.36 at 11 years (95% CI 1.01 to 1.83), after adjusting for gender, diabetes, hypertension, smoking, obesity, HDL and triglyceride serum levels. The first 5% of the individuals had a cardiovascular event nearly 2 years earlier among those with ApoB ≥0.9 g/l than among those with ApoB <0.9 g/l (p=0.001).
  
  
  CONCLUSIONS
  Our data indicate that increased ApoB serum levels are important predictors of early cardiovascular events. It is possible that this reflects a shift over time in the effects of apoB from a more pro-thrombotic to a more pro-atherogenetic molecule.
authors: Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, IMM, Nobelsväg 13, Karolinska Institutet, 17177 Stockholm, Sweden. bruna.gigante@ki.se
authors: Bruna
authors: B
authors: Gigante
authors: Karin
authors: K
authors: Leander
authors: Max
authors: M
authors: Vikstrom
authors: Paolo
authors: P
authors: Frumento
authors: Axel C
authors: AC
authors: Carlsson
authors: Matteo
authors: M
authors: Bottai
authors: Ulf
authors: U
authors: de Faire
mesh_terms: D001055:Apolipoproteins B / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D001055:Apolipoproteins B; D015415:Biomarkers