Prevention & lipidsCohort study
Low-density lipoprotein cholesterol, C-reactive protein, and lipoprotein(a) universal one-time screening in primary prevention: the EPIC-Norfolk study
- Prospective cohort study
Authors' conclusion
A single combined measure of LDL cholesterol, hsCRP, and Lp(a) among initially healthy European men and women was predictive of incident MACE during a 20-year period.
Study context
- Population
- Initially healthy European men and women, EPIC-Norfolk study (primary prevention)
- Participants
- 17,087 men
- Exposure
- Top vs bottom quintile of LDL-C, high-sensitivity C-reactive protein (hsCRP) and Lp(a); number of biomarkers in top quintile
- Outcome
- Incident MACE
- Follow-up
- 20 years
Main finding
As reported in the abstract
Incident MACE by baseline biomarker quintile
Hazard ratio (95% CI)
LDL-C top quintile vs bottom quintile
1.78(1.57–2.00)
hsCRP top quintile vs bottom quintile
1.55(1.37–1.74)
Lp(a) top quintile vs bottom quintile
1.19(1.07–1.33)
- One biomarker in top quintile vs No biomarker elevations
- HR 1.33; P < 0.001
- Two biomarkers in top quintile vs No biomarker elevations
- HR 1.68; P < 0.001
- Three biomarkers in top quintile vs No biomarker elevations
- HR 2.41; P < 0.001
- Total major adverse cardiovascular events (MACEs) during follow-up
- 3249
Observational data: associations, not effects.
Further findings
Independence and sex-stratified analyses
- Each biomarker contributed independently; findings consistent when stratified by sex
Original publication
Low-density lipoprotein cholesterol, C-reactive protein, and lipoprotein(a) universal one-time screening in primary prevention: the EPIC-Norfolk study. Eur Heart J. Published 1 April 2025. doi:10.1093/eurheartj/ehaf209
Summarised from the published abstract; every number is checked against it