{"id":138430,"date":"2024-08-31T16:55:51","date_gmt":"2024-08-31T20:55:51","guid":{"rendered":"https:\/\/cardiologynownews.org\/?p=138430"},"modified":"2024-08-31T16:56:55","modified_gmt":"2024-08-31T20:56:55","slug":"a-single-combined-measure-of-hscrp-ldl-c-and-lpa-predicts-incident-cv-events-over-30-years-among-womens-health-study-participants","status":"publish","type":"post","link":"https:\/\/cardiologynownews.org\/?p=138430","title":{"rendered":"A Single Combined Measure Of hsCRP, LDL-C, And Lp(A) Predicts Incident CV Events Over 30 Years Among Women\u2019s Health Study Participants"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Key Points:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">While drug trials evaluate the short-term cardiovascular risk associated with elevated, blood biomarkers, little is known about the long term (20-30 year) risk conferred by these biomarkers, alone or in combination.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">This epidemiological study evaluated the association between baseline levels of hsCRP, LDL-C, and Lp(a) of ~28,000 initially healthy participants in the Women\u2019s Health Study with incident cardiovascular events over 30 years of follow-up.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Each of the measures were independently associated with an increased adjusted hazard of incident cardiovascular events, and each biomarker provided additive information. Women in the highest quintile of all three biomarkers had the highest risk.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">These data indicate that a single combined measure at one point in time can have predictive value beyond the traditional 10-year risk score. Since all three are potentially modifiable, these findings might have significant implications for how we prevent heart disease.\u00a0<\/span><\/li>\n<\/ul>\n<p><!--more--><\/p>\n<p><span style=\"font-weight: 400;\">Atherosclerosis develops over decades before becoming clinically apparent.\u00a0 Early and accurate risk stratification using modifiable biomarkers can help us identify not just who to target, but also what to target with preventative interventions.<\/span><span style=\"font-weight: 400;\">On August 31<\/span><span style=\"font-weight: 400;\">st<\/span><span style=\"font-weight: 400;\"> 2024, the principal results of the \u201cInflammation, Cholesterol, Lipoprotein(a), and 30-Year Cardiovascular Outcomes in Women\u201d was presented at ESC Congress 2024 with simultaneous publication in the <\/span><i><span style=\"font-weight: 400;\">New England Journal of Medicine<\/span><\/i><span style=\"font-weight: 400;\">. The purpose of this study w as to determine if a single mid-life baseline measure of high sensitivity C-reative protein (hsCRP), low-density lipoprotein cholesterol (LDL-C), and lipoprotein(a) (Lp(a)) obtained in midlife could predict incident cardiovascular risk over a 30 year period, alone or in combination.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">This analysis included 27,939 initially health participants in the Women\u2019s Health Study who had each measure assessed at baseline, with a mean starting age of 54.7 years.\u00a0 The exposure was the quintile level of each biomarker, alone and in combination.\u00a0 The primary outcome was time to first major cardiovascular events (centrally adjusted myocardial infarction, revascularization, ischemic stroke, or cardiovascular death) over 30 years. Cause specific Cox proportional models were used to estimate 30 years hazard ratios, adjusted for age, smoking, diabetes, blood pressure, renal function, use of hormone replacement, and body mass index, accounting for competing risks of death.\u00a0 <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Individually, elevated hsCRP had the highest risk for the composite endpoint (HR 1.70 [95% CI 1.52-1.90]), followed by LDL-C (HR 1.36 [1.23-1.52]) then Lp(a) (HR 1.33 [1.21-1.47]). Compared to having none of the three biomarkers in the top quintile, having all three biomarkers in the top quintile was associated with a significantly increased risk of coronary (HR 3.7 [95% CI 2.9-4.7]) and ischemic stroke (HR 1.7 [95% CI 1.1-2.5]) events.\u00a0 The biomarkers were each independently predictive as well as additive.\u00a0 There was a stepwise increase in the hazard for the primary outcomes with each additional elevated biomarker.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Dr. Paul Ridker from the Brigham and Women\u2019s Hospital, Boston, MA, concluded: \u201cA single combined measure of hsCRP, LDL-C and Lp(a) among initially health American women was predictive of incident cardiovascular events over a 30 year period.\u00a0 As each of these is modifiable, these data support efforts to extend strategies for primary prevention well beyond traditional 10-year estimates of risk. We need to focus on lifelong risk and lifelong interventions\u2026We need to focus on prevention among younger women for whom CVD remains underdiagnosed and undertreated\u2026The time has come for universal screening of 3 simple modifiable risk factors.\u201d<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Key Points: While drug trials evaluate the short-term cardiovascular risk associated with elevated, blood biomarkers, little is known about the long term (20-30 year) risk conferred by these biomarkers, alone or in combination. This epidemiological study evaluated the association between baseline levels of hsCRP, LDL-C, and Lp(a) of ~28,000 initially healthy participants in the Women\u2019s [&hellip;]<\/p>\n","protected":false},"author":40603,"featured_media":11007,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[892,8],"tags":[45,893,47,185],"ppma_author":[1029],"class_list":{"0":"post-138430","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-esc-2024","8":"category-news","9":"tag-conference","10":"tag-esc-2024","11":"tag-featured","12":"tag-news","13":"author-leah-kosyakovsky"},"authors":[{"term_id":1029,"user_id":40603,"is_guest":0,"slug":"leah-kosyakovsky","display_name":"Leah Kosyakovsky","avatar_url":"https:\/\/secure.gravatar.com\/avatar\/864bde69f6f1f80e91e4a97f0a0ba8daa64c2bb702be09ed787444c7dfa045bb?s=96&r=g","0":null,"1":"","2":"","3":"","4":"","5":"","6":"","7":"","8":""}],"_links":{"self":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138430","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/users\/40603"}],"replies":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=138430"}],"version-history":[{"count":2,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138430\/revisions"}],"predecessor-version":[{"id":138432,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138430\/revisions\/138432"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/media\/11007"}],"wp:attachment":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=138430"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=138430"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=138430"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fppma_author&post=138430"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}