The main findings are: (i) patients in the highest apoA‐IV quartile had the lowest hs‐CRP values despite the lowest eGFR and the highest prevalence of diabetes and albuminuria, (ii) higher apoA‐IV concentrations at baseline were associated with lower odds of prevalent CVD, and (iii) during 6.5 years of follow‐up, higher apoA‐IV concentrations were associated with a lower risk of all‐cause mortality, MACE and heart failure. Here, APOA4 is linked to heart failure.