N Engl J Med

ESC 2024: Three biomarkers predict 30-year risk of heart disease in women

September 4, 2024

In a study of initially healthy U.S. women, a combined measure of high-sensitivity CRP (hsCRP), LDL-cholesterol, and lipoprotein(a) (lp(a)) levels predicted CV events over 30 years. These findings, which were presented at the recent European Society of Cardiology meeting in London, provide an argument for expanding primary prevention strategies for atherosclerotic events beyond the conventional 10-year risk estimates.

• In this analysis of the Women’s Health Study, researchers measured hsCRP, LDL-cholesterol, and lp(a) levels at baseline in 27,939 initially healthy U.S. women (mean age, 54.7 years) who were subsequently followed for 30 years. Primary end point was a first major adverse CV event (a composite of MI, coronary revascularization, stroke, or death from CV causes).
• Quintiles of increasing baseline levels of hsCRP, LDL, and lp(a) all predicted 30-year risks. Women with the highest levels of LDL-cholesterol had a 36% increased risk for heart disease compared with those with the lowest levels. Those with the highest levels of Lp(a) had a 33% increased risk, and those with the highest levels of CRP had a 70% increased risk.
• While each biomarker showed independent contributions to overall risk, the greatest spread for risk was obtained in models that incorporated all three biomarkers.

Source:

Ridker PM, et al. (2024, August 31). N Engl J Med. Inflammation, Cholesterol, Lipoprotein(a), and 30-Year Cardiovascular Outcomes in Women. https://pubmed.ncbi.nlm.nih.gov/39216091/