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Residual cardiovascular risk is tracked by apolipoprotein B in coronary patients with elevated serum triglyceride levels : the ESC EORP EUROASPIRE IV survey

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Abstract
Background and aims Based on data from the EUROASPIRE IV survey, we aimed at assessing the possible residual risk tracked by serum apolipoprotein B in coronary patients with elevated serum triglycerides. Methods All samples from the total EUROASPIRE IV survey (n = 7998) with low serum total cholesterol (<4.5 mmol/L) and high serum triglycerides (>= 1.7 mmol/L) were used to analyse apolipoprotein A-I (apoA-I) and apolipoprotein B (apoB) concentrations (n = 938). We selected a similar number of participants (n = 938) with low total cholesterol and with low triglycerides (<1.0 mmol/L). In addition, phospholipid transfer protein (PLTP) and cholesteryl ester transfer protein (CETP) as well as paraoxonase-1 (PON-1), angiopoietin-like (ANGPTL)-3 and ANGPTL-8 were analysed in randomly selected participants. Results Despite the lower low-density lipoprotein cholesterol (LDL-C) concentration in the patients with TG >= 1.7 mmol/L (1.89 +/- 0.44 mmol/L) than those with TG < 1.0 mmol/L (1.99 +/- 0.43 mmol/L), p < 0.0001), serum total cholesterol, apoB, and HbA1c were all significantly (p < 0.0001) higher in patients with TG >= 1.7 mmol/L. In addition, high-density lipoprotein cholesterol (HDL-C), apoA-I, and CETP activity were significantly lower (p < 0.001) in these patients. The prevalence of obesity and diabetes was higher in the participants with TG >= 1.7 mmol/L than in those with TG < 1.0 mmol/L (52.6 % vs 21.9 % and 41.3 % vs. 20.0 %). Conclusions Statin treatment is mainly decreasing serum LDL-C concentration, but apoB measurements with excess serum triglycerides carried by apoB-containing lipoproteins could provide more specific information about the risk assessment of cardiovascular disease in atherogenic dyslipidemia.
Keywords
Triglycerides, Apolipoprotein B, LDL-C, Cardiovascular disease, HEART-DISEASE, NONFASTING TRIGLYCERIDES, REMNANT CHOLESTEROL, MANAGEMENT, ANGPTL3, LDL, DYSLIPIDEMIA, ASSOCIATION, PREVENTION, STILL

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MLA
Leiviskä, Jaana, et al. “Residual Cardiovascular Risk Is Tracked by Apolipoprotein B in Coronary Patients with Elevated Serum Triglyceride Levels : The ESC EORP EUROASPIRE IV Survey.” CLINICA CHIMICA ACTA, vol. 579, 2026, doi:10.1016/j.cca.2025.120653.
APA
Leiviskä, J., Sundvall, J., Jauhiainen, M., Kotseva, K., Tuomilehto, J., De Backer, G., … De Bacquer, D. (2026). Residual cardiovascular risk is tracked by apolipoprotein B in coronary patients with elevated serum triglyceride levels : the ESC EORP EUROASPIRE IV survey. CLINICA CHIMICA ACTA, 579. https://doi.org/10.1016/j.cca.2025.120653
Chicago author-date
Leiviskä, Jaana, Jouko Sundvall, Matti Jauhiainen, Kornelia Kotseva, Jaakko Tuomilehto, Gui De Backer, Lâle Tokgözoğlu, Zeljko Reiner, and Dirk De Bacquer. 2026. “Residual Cardiovascular Risk Is Tracked by Apolipoprotein B in Coronary Patients with Elevated Serum Triglyceride Levels : The ESC EORP EUROASPIRE IV Survey.” CLINICA CHIMICA ACTA 579. https://doi.org/10.1016/j.cca.2025.120653.
Chicago author-date (all authors)
Leiviskä, Jaana, Jouko Sundvall, Matti Jauhiainen, Kornelia Kotseva, Jaakko Tuomilehto, Gui De Backer, Lâle Tokgözoğlu, Zeljko Reiner, and Dirk De Bacquer. 2026. “Residual Cardiovascular Risk Is Tracked by Apolipoprotein B in Coronary Patients with Elevated Serum Triglyceride Levels : The ESC EORP EUROASPIRE IV Survey.” CLINICA CHIMICA ACTA 579. doi:10.1016/j.cca.2025.120653.
Vancouver
1.
Leiviskä J, Sundvall J, Jauhiainen M, Kotseva K, Tuomilehto J, De Backer G, et al. Residual cardiovascular risk is tracked by apolipoprotein B in coronary patients with elevated serum triglyceride levels : the ESC EORP EUROASPIRE IV survey. CLINICA CHIMICA ACTA. 2026;579.
IEEE
[1]
J. Leiviskä et al., “Residual cardiovascular risk is tracked by apolipoprotein B in coronary patients with elevated serum triglyceride levels : the ESC EORP EUROASPIRE IV survey,” CLINICA CHIMICA ACTA, vol. 579, 2026.
@article{01KFG3SET3G7T9GQ8T03HREXJ7,
  abstract     = {{Background and aims Based on data from the EUROASPIRE IV survey, we aimed at assessing the possible residual risk tracked by serum apolipoprotein B in coronary patients with elevated serum triglycerides. Methods All samples from the total EUROASPIRE IV survey (n = 7998) with low serum total cholesterol (<4.5 mmol/L) and high serum triglycerides (>= 1.7 mmol/L) were used to analyse apolipoprotein A-I (apoA-I) and apolipoprotein B (apoB) concentrations (n = 938). We selected a similar number of participants (n = 938) with low total cholesterol and with low triglycerides (<1.0 mmol/L). In addition, phospholipid transfer protein (PLTP) and cholesteryl ester transfer protein (CETP) as well as paraoxonase-1 (PON-1), angiopoietin-like (ANGPTL)-3 and ANGPTL-8 were analysed in randomly selected participants. Results Despite the lower low-density lipoprotein cholesterol (LDL-C) concentration in the patients with TG >= 1.7 mmol/L (1.89 +/- 0.44 mmol/L) than those with TG < 1.0 mmol/L (1.99 +/- 0.43 mmol/L), p < 0.0001), serum total cholesterol, apoB, and HbA1c were all significantly (p < 0.0001) higher in patients with TG >= 1.7 mmol/L. In addition, high-density lipoprotein cholesterol (HDL-C), apoA-I, and CETP activity were significantly lower (p < 0.001) in these patients. The prevalence of obesity and diabetes was higher in the participants with TG >= 1.7 mmol/L than in those with TG < 1.0 mmol/L (52.6 % vs 21.9 % and 41.3 % vs. 20.0 %). Conclusions Statin treatment is mainly decreasing serum LDL-C concentration, but apoB measurements with excess serum triglycerides carried by apoB-containing lipoproteins could provide more specific information about the risk assessment of cardiovascular disease in atherogenic dyslipidemia.}},
  articleno    = {{120653}},
  author       = {{Leiviskä, Jaana and Sundvall, Jouko and Jauhiainen, Matti and Kotseva, Kornelia and Tuomilehto, Jaakko and De Backer, Gui and Tokgözoğlu, Lâle and Reiner, Zeljko and De Bacquer, Dirk}},
  issn         = {{0009-8981}},
  journal      = {{CLINICA CHIMICA ACTA}},
  keywords     = {{Triglycerides,Apolipoprotein B,LDL-C,Cardiovascular disease,HEART-DISEASE,NONFASTING TRIGLYCERIDES,REMNANT CHOLESTEROL,MANAGEMENT,ANGPTL3,LDL,DYSLIPIDEMIA,ASSOCIATION,PREVENTION,STILL}},
  language     = {{eng}},
  pages        = {{6}},
  title        = {{Residual cardiovascular risk is tracked by apolipoprotein B in coronary patients with elevated serum triglyceride levels : the ESC EORP EUROASPIRE IV survey}},
  url          = {{http://doi.org/10.1016/j.cca.2025.120653}},
  volume       = {{579}},
  year         = {{2026}},
}

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