Eur Heart J

Can one-time universal screening for three biomarkers predict long-term CV risk?

May 7, 2025

A combined measure of LDL cholesterol (LDL-C), high-sensitivity C-reactive protein (hsCRP), and lipoprotein(a) (Lp(a)) predicted major cardiovascular events over 20 years in initially healthy Europeans. The findings support universal screening for these biomarkers in primary prevention, replicating recent findings from an American study.

Study details: The EPIC-Norfolk study investigated the predictive value of a one-time universal screening for LDL-C, hsCRP, and Lp(a) in primary prevention. This prospective cohort study included 17,087 initially healthy European men and women, with baseline measurements taken between 1993 and 1997. Participants were followed for 20 years to monitor major adverse cardiovascular events (MACEs).

Results: During the follow-up period, 3,249 MACEs occurred. Higher quintiles of baseline LDL-C, hsCRP, and Lp(a) were independently associated with increased 20-year risk of MACE. The multivariable-adjusted hazard ratios (HRs) comparing the highest to lowest quintiles were 1.78 for LDL-C, 1.55 for hsCRP, and 1.19 for Lp(a). Participants with elevations in all three biomarkers had the highest risk, with HRs of 2.41, 1.68, and 1.33 for three, two, and one elevated biomarker(s), respectively.

Source:

Kraaijenhof JM, et al. (2025, April 1). Eur Heart J. Low-density lipoprotein cholesterol, C-reactive protein, and lipoprotein(a) universal one-time screening in primary prevention: the EPIC-Norfolk study. https://pubmed.ncbi.nlm.nih.gov/40167249/