Physicians' Academy for Cardiovascular Education

Insights in association plasma apo CIII levels with CAD risk

Apolipoprotein CIII Levels and Incident Coronary Artery Disease Risk: The EPIC-Norfolk Prospective Population Study

Literature - Van Capelleveen JC, Bernelot Moens SJ, Yang X, et al. - Arterioscler Thromb Vasc Biol. 2017; 37: published online ahead of print


Apo CIII is a key regulator of the metabolism of triglyceride-rich lipoproteins and has been associated with increased coronary artery disease (CAD) risk [1,2]. According to genetic studies, the loss-of-function mutations in APOC3 result in a favorable lipid profile with reduced triglyceride and VLDL levels, whereas Mendelian randomization studies showed a causal relationship between genetic variation in APOC3 and CAD risk [3-5]. However, it is not clear yet, which factors mediate the impact of elevated apo CIII on CAD risk.

In this large prospective EPIC-Norfolk nested case–control study with 2711 healthy participants (of whom 832 developed CAD), the associations between apo CIII levels, detailed lipoprotein analyses, inflammatory markers and CAD risk were evaluated to explore which lipoprotein subfractions contribute to the relationship between apoCIII and CAD risk.

Main results


There is a strong association between elevated plasma apo CIII levels with CAD risk, independently of traditional cardiovascular disease risk factors, which may be explained by elevated levels of remnant lipoproteins, small dense LDL and low-grade inflammation.


Show references

Find this article online at Arterioscler Thromb Vasc Biol.

Share this page with your colleagues and friends: