Prevention & lipidsMeta-analysis
C-reactive protein modifies lipoprotein(a)-related risk for coronary heart disease: the BiomarCaRE project
- Pooled analysis of prospective population-based cohort studies
- 8 European cohorts
- competing risk-adjusted (Fine and Gray)
Authors' conclusion
While among CHD-free individuals Lp(a) was significantly associated with incident CHD regardless of hsCRP, in participants with CHD at baseline, Lp(a) was related to recurrent CHD events only in those with residual inflammatory risk.
Study context
- Population
- General population, with and without established coronary heart disease (CHD) at baseline (BiomarCaRE)
- Participants
- 71,678 participants · 8 cohorts
- Comparison
- Highest vs lowest fifth of Lp, by high-sensitive C-reactive protein (hsCRP) <2 vs ≥2 mg/L
- Outcome
- Incident or recurrent CHD by Lp(a) fifth, according to hsCRP
- Follow-up
- Median 9.8/13.8 years
Pooled result
As reported in the abstract
Incident CHD, CHD-free at baseline (Lp(a) highest vs lowest fifth)
Subdistribution hazard ratio (95% CI)
hsCRP <2 mg/L
1.45(1.23–1.72)
hsCRP ≥2 mg/L
1.48(1.23–1.78)
Further pooled results
Recurrent CHD events, established CHD at baseline (Lp(a) highest vs lowest fifth)
| Comparison | sHR (95% CI) | |
|---|---|---|
| hsCRP ≥2 mg/L · fully adjusted | 1.34 (1.03–1.76) | |
| hsCRP <2 mg/L · fully adjusted; no clear association | 1.29 (0.98–1.71) | |
| 0.512Subdistribution hazard ratio (log scale) |
- Recurrent CHD events, established CHD at baseline (Lp(a) highest vs lowest fifth): n = 6017 with CHD
- Recurrent CHD events, established CHD at baseline (Lp(a) highest vs lowest fifth): interaction P = 0.024
Original publication
C-reactive protein modifies lipoprotein(a)-related risk for coronary heart disease: the BiomarCaRE project. Eur Heart J. Published 18 January 2024. doi:10.1093/eurheartj/ehad867
Summarised from the published abstract; every number is checked against it