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Occurrence of coronary events in the absence of traditional risk factors: Understanding residual risk

Title: Occurrence of coronary events in the absence of traditional risk factors: Understanding residual risk
Authors: Arnold N.; Gossling A.; Weimann J.; Bay B.; Zeller T.; Ferrario M.; Palmieri L.; Amouyel P.; Moitry M.; Ferrieres J.; Brenner H.; Tamosiunas A.; Malyutina S.; Mannisto S.; Drygas W.; Grassi G.; Grimsgaard S.; Linneberg A.; Soderberg S.; Iacoviello L.; Sans S.; Schnabel R.; Veronesi G.; Thorand B.; Tunstall-Pedoe H.; Kee F.; Salomaa V.; Kuulasmaa K.; Blankenberg S.; Waldeyer C.; Ojeda F.; Magnussen C.; Koenig W.
Contributors: Arnold, N.; Gossling, A.; Weimann, J.; Bay, B.; Zeller, T.; Ferrario, M.; Palmieri, L.; Amouyel, P.; Moitry, M.; Ferrieres, J.; Brenner, H.; Tamosiunas, A.; Malyutina, S.; Mannisto, S.; Drygas, W.; Grassi, G.; Grimsgaard, S.; Linneberg, A.; Soderberg, S.; Iacoviello, L.; Sans, S.; Schnabel, R.; Veronesi, G.; Thorand, B.; Tunstall-Pedoe, H.; Kee, F.; Salomaa, V.; Kuulasmaa, K.; Blankenberg, S.; Waldeyer, C.; Ojeda, F.; Magnussen, C.; Koenig, W.
Publication Year: 2025
Collection: IRInSubria - Institutional Repository Insubria (Università degli Studi dell’Insubria)
Subject Terms: Cardiovascular risk factors (CVRFs); Circulating biomarker; Coronary heart disease; General population; High-sensitivity C-Reactive protein (hsCRP); Triglycerides
Description: Background and aims: The major predictors of future coronary heart disease (CHD) events in individuals without traditional modifiable cardiovascular risk factors (CVRFs) remain unknown. We investigated the association between circulating biomarkers, reflecting residual risk, with incident CHD in a general population, according to the presence of five CVRFs (hypertension, diabetes mellitus, hypercholesterolemia, smoking and obesity) at baseline. Methods: Overall 212,598 CHD-free individuals from 21 European population-based cohorts were stratified by CVRF burden into three groups, having zero (n = 35,707), one (n = 68,548) or ≥2 (n = 108,343) risk factors at baseline. Five biomarkers (triglycerides (TGs), high-sensitivity C-reactive protein (hsCRP), cystatin C, N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin I) were assessed in a subset with available measurements. Results: During a median follow-up of 13.97 years, 17,499 participants developed incident CHD with 453 events occurring among individuals without CVRFs. Although increased concentrations of all biomarkers were related to incident CHD, significant risk modulation by CVRFs was seen only for TGs and, to a lesser extent, for hsCRP. The fully-adjusted sub-distribution Hazard Ratios (95 % CI) were for TGs (≥vs < 1.70 mmol/L) 1.66 (1.29–2.15) in those without CVRFs versus 1.35 (1.21–1.49)/1.14 (1.07–1.20) in those with 1 or ≥2 risk factors (pinteraction
Document Type: article in journal/newspaper
File Description: ELETTRONICO
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/40829292; info:eu-repo/semantics/altIdentifier/wos/WOS:001554455400001; volume:409; firstpage:1; lastpage:9; numberofpages:9; journal:ATHEROSCLEROSIS; https://hdl.handle.net/11383/2197751; https://www.sciencedirect.com/science/article/pii/S0021915025013735
DOI: 10.1016/j.atherosclerosis.2025.120475
Availability: https://hdl.handle.net/11383/2197751; https://doi.org/10.1016/j.atherosclerosis.2025.120475; https://www.sciencedirect.com/science/article/pii/S0021915025013735
Rights: info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.590FDDF3
Database: BASE