Prevention & lipidsCohort study
Combining Genomics With Lipid and Inflammatory Biomarkers to Predict Coronary Artery Disease Risk
- Prospective cohort study
Authors' conclusion
CAD PRS, LDL-C, hsCRP, and Lp(a) show independent age- and sex-specific associations with CAD.
Study context
- Population
- UK Biobank participants aged 40 to 69 years with baseline coronary artery disease (CAD) polygenic risk score (PRS), low-density-lipoprotein cholesterol (LDL-C), Lp(a) and high-sensitivity C-reactive protein (hsCRP) values
- Participants
- 215,695 participants
- Exposure
- CAD PRS, LDL-C, Lp and hsCRP vs pooled cohort equations
- Outcome
- Incident CAD
- Follow-up
- 12-year follow-up
Main finding
As reported in the abstract
Incident CAD per biomarker elevation
Hazard ratio (95% CI)
CAD PRS
1.79(1.70–1.89)
LDL-C
1.60(1.48–1.66)
Lp(a)
1.20(1.12–1.29)
hsCRP
1.64(1.57–1.72)
Per biomarker elevation, as printed
- Incident CAD, men
- 4,721
- Incident CAD, women
- 2,425
- All biomarkers elevated vs none elevated: fold increased risk of CAD
- 4.65
Observational data: associations, not effects.
Further findings
| Outcome | HR per SD (95% CI) | |
|---|---|---|
| CAD PRS by sex (HR per SD) — CAD PRS, men | 1.49 (1.45–1.54) | |
| CAD PRS by sex (HR per SD) — CAD PRS, women | 1.37 (1.31–1.44) | |
| 0.512Hr per sd (log scale) |
- CAD PRS by sex (HR per SD): P-interaction ≤ 0.001
Biomarker HRs by age
- All biomarkers conferred greater HRs at younger ages
- P < 0.0001
Discrimination and reclassification
- C-statistic, combined 4-biomarker model
- 0.753
- C-statistic, pooled cohort equations
- 0.740
- Continuous net reclassification index, 4-biomarker model vs pooled cohort equations
- 32.0%
- C-statistic of 4-biomarker model higher in younger individuals in both sexes
Original publication
Combining Genomics With Lipid and Inflammatory Biomarkers to Predict Coronary Artery Disease Risk. J Am Coll Cardiol. Published 18 March 2026. doi:10.1016/j.jacc.2026.01.076
Summarised from the published abstract; every number is checked against it