Send to

Choose Destination
See comment in PubMed Commons below
J Clin Lipidol. 2015 Jul-Aug;9(4):498-510. doi: 10.1016/j.jacl.2015.05.002. Epub 2015 May 14.

The risk of cardiovascular events with increased apolipoprotein CIII: A systematic review and meta-analysis.

Author information

  • 1Division of Cardiothoracic Surgery, Department of Surgery, Froedtert Memorial Hospital, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address:
  • 2Department of Internal Medicine I, Comprehensive Heart Failure Center, University of Würzburg, Bavaria, Germany.
  • 3Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.



Apolipoprotein CIII (apoC-III) is an atherogenic protein found on HDL, VLDL and LDL.


The objective of this study is to review the literature on the association of blood apoC-III level with cardiovascular events and the dose-response relationship for this association.


MEDLINE, EMBASE, BIOSIS, CINAHL,, grey-literature sources, contact with investigators, and reference lists of studies, without language restrictions, were reviewed. Twelve studies (5 retrospective and 7 prospective) with a total of 3163 cases of cardiovascular events met inclusion criteria for this systematic review. The pooled standardized mean difference showed significantly higher levels of apoC-III in the non-HDL fraction of plasma (representing apoC-III in VLDL and LDL) in those with cardiovascular disease compared with controls; no difference for apoC-III levels in HDL; and, a trend toward higher total plasma apoC-III in the cases. Pooled risk estimates from the meta-analysis were 2.48 (1.48-4.32; non-HDL apoC-III), 1.09 (0.65-1.82; HDL apoC-III), and 1.33 (1.07-1.66; total apoC-III) for a cardiovascular event with a 5-mg/dL increase in apoC-III.


The current body of literature includes several methodologically sound studies that together provide consistent evidence for an association of cardiovascular events with blood apoC-III level in total plasma or in VLDL and LDL. More data are needed to determine importance of levels of apoC-III in specific lipoproteins for cardiovascular risk assessment and management and to elucidate the interaction between triglycerides and apoC-III in relation to risk of cardiovascular disease.


Atherosclerosis; Cardiovascular risk; Epidemiology; Lipoprotein

[PubMed - indexed for MEDLINE]
Free full text
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center