Coronary disease & ACSCohort study
The junctional protein associated with coronary artery disease predicts adverse cardiovascular events in patients with acute coronary syndromes at high residual risk
- Prospective cohort study
- propensity-score matched
- external validation cohort
Authors' conclusion
Acute coronary syndrome patients at RLR, RIR, or both are at high ischaemic risk.
Study context
- Population
- Patients with acute coronary syndromes (ACS) (SPUM-ACS discovery cohort; RISK-PPCI validation cohort)validation cohort n = 496
- Participants
- 4,787 patients
- Exposure
- Residual lipid, inflammatory or combined risk vs matched controls; JCAD and major adverse cardiovascular events (MACE)
- Outcome
- Recurrent MACE
- Follow-up
- 1 year
Main finding
As reported in the abstract
MACE
Each group vs controlsHazard ratio (95% CI)
RLR
1.55(1.08–2.23)
RIR
1.80(1.24–2.61)
RILR
1.75(1.12–2.75)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| MACE per log2 increase in hs-CRP and JCAD, RLR (subgroup) — hs-CRP per log2 increase · univariable | HR 1.17 (95% CI 1.06–1.30) | |
| MACE per log2 increase in hs-CRP and JCAD, RLR (subgroup) — JCAD per log2 increase · univariable | HR 1.29 (95% CI 1.03–1.62) | |
| MACE per log2 increase in hs-CRP and JCAD, RLR (subgroup) — hs-CRP per log2 increase · multivariable-adjusted | aHR 1.16 (95% CI 1.03–1.30) | |
| MACE per log2 increase in hs-CRP and JCAD, RLR (subgroup) — JCAD per log2 increase · multivariable-adjusted | aHR 1.27 (95% CI 1.01–1.60) | |
| MACE per log2 increase in JCAD, RIR (subgroup) — JCAD per log2 increase · univariable | HR 1.28 (95% CI 1.03–1.59) | |
| MACE per log2 increase in JCAD, RIR (subgroup) — JCAD per log2 increase · multivariable-adjusted | aHR 1.31 (95% CI 1.04–1.65) | |
| MACE with increasing JCAD, RILR (subgroup) — JCAD vs Controls · unadjusted | HR 1.45 (95% CI 1.09–1.92) | |
| MACE with increasing JCAD, RILR (subgroup) — JCAD vs Controls · independent of potential confounders | aHR 1.47 (95% CI 1.11–1.97) | |
| 0.512Ratio (log scale) |
JCAD, fibrinolysis and external validation
- Plasma JCAD correlated positively with proxies of impaired endogenous fibrinolysis
- JCAD-MACE association similarly observed in the external validation cohort
Original publication
The junctional protein associated with coronary artery disease predicts adverse cardiovascular events in patients with acute coronary syndromes at high residual risk. Eur Heart J. Published 23 December 2025. doi:10.1093/eurheartj/ehaf979
Summarised from the published abstract; every number is checked against it