Prevention & lipidsCohort study
Integrative assessment of high-sensitivity C-reactive protein and lipid levels in predicting 20-year atherosclerotic cardiovascular disease risk, in a Mediterranean population: The ATTICA study (2002-2022)
- cohort
- 20-year follow-up
Authors' conclusion
Hs-CRP provides independent, incremental predictive value, even beyond advanced lipid metrics, and is a potent residual risk factor in contexts traditionally considered low-risk.
Study context
- Population
- Atherosclerotic cardiovascular disease (ASCVD)-free adults residing in greater Athens, Greece, recruited in 2002recruited in 2002, n = 2,169 at 20-year follow-up, of which n = 1,988 had complete data for cardiovascular disease incidence
- Participants
- 3,042 adults
- Exposure
- Combined high-sensitivity C-reactive protein (hs-CRP) and various atherogenic lipid measures (discordance between biomarkers, defined by guideline-recommended thresholds) and long-term 3-point MACE risk
Main finding
As reported in the abstract
Incident 3-point MACE: hs-CRP as predictor · 20 years
- Hs-CRP was an independent predictor after adjusting for low-density lipoprotein cholesterol (LDL-C) or non-HDL-C, but not apolipoprotein B (apoB) or Lp(a)
Observational data: associations, not effects.
Further findings
Incident 3-point MACE by apoB and hs-CRP
- High levels of apoB (≥100 mg/dL) associated with an increased 3-point MACE risk regardless of hs-CRP levels
Incident 3-point MACE by LDL-C, non-HDL-C and hs-CRP
- Elevated LDL-C (≥100 mg/dL) and non-HDL-C (≥131 mg/dL) significant associations only in the presence of hs-CRP ≥ 2 mg/L
Original publication
Integrative assessment of high-sensitivity C-reactive protein and lipid levels in predicting 20-year atherosclerotic cardiovascular disease risk, in a Mediterranean population: The ATTICA study (2002-2022). Am Heart J. Published 11 July 2026. doi:10.1016/j.ahj.2026.107540
Summarised from the published abstract; every number is checked against it