Prevention & lipidsCohort study
Characterization of biomarker profiles in patients with coronary artery disease: A prospective coronary computed tomography angiography study
- prospective coronary computed tomography angiography study
- prospective ACTION registry
- machine learning unsupervised clustering
Authors' conclusion
Distinct biomarker signatures associate with distinct CAD prevalence and severity that conventional lipid markers fail to distinguish. Lp(a) appears relevant for early plaque detection in coronary artery calcium = 0 patients. A comprehensive biomarker evaluation may help identifying high-risk subgroups overlooked by a conventional assessment.
Study context
- Population
- Patients on primary prevention who underwent coronary CTA and simultaneous biomarker testing (January 2024 to June 2025)patients on primary prevention from the prospective ACTION registry, 382 (48.5%) with coronary artery calcium = 0
- Participants
- 787 patients
- Exposure
- associations between multiple biomarkers and different coronary artery disease (CAD) phenotypes, exploring a machine-learning biomarker-based patient clustering
Main finding
As reported in the abstract
Of 382 patients (48.5%) with coronary artery calcium = 0, had coronary plaque
42 (11%)
Observational data: associations, not effects.
Further findings
Prevalence of CAD-RADS ≥ 3 by biomarker cluster · significantly higher prevalence in clusters 2 and 3
P = 0.001
High-risk biomarker signatures and prevalence of CAD-RADS ≥ 3
| Comparison | adjusted odds ratio (95% CI) | P value | |
|---|---|---|---|
| High-risk biomarker signatures · independently from the baseline SCORE2 | 2.25 (1.32–3.82) | ||
| 0.20.5125Adjusted odds ratio (log scale) |
| Outcome | Estimate | P value |
|---|---|---|
| Lp(a) and SCORE2 in coronary artery calcium = 0 patients with vs without plaque — With plaque vs Without plaque · Lp(a) higher with plaque | P = 0.030 | |
| Lp(a) and SCORE2 in coronary artery calcium = 0 patients with vs without plaque — With plaque vs Without plaque · SCORE2 comparable | P = 0.284 |
- Lp(a) and SCORE2 in coronary artery calcium = 0 patients with vs without plaque: With plaque Lp(a) 16.5 · SCORE2 3.5%
- Lp(a) and SCORE2 in coronary artery calcium = 0 patients with vs without plaque: Without plaque Lp(a) 11.5 · SCORE2 3.0%
- Prevalence of CAD-RADS ≥ 3 by biomarker cluster: Cluster 2 and 3 had significant intercluster differences in Lp(a), low-density lipoprotein (LDL), and HbA1c levels
Original publication
Summarised from the published abstract; every number is checked against it