How should we proceed today with primary prevention of cardiovascular disease – data affects women

Czech version

Authors: Ján Murín
Authors‘ workplace: I. interná klinika LF UK a UNB, Nemocnica Staré Mesto, Bratislava
Published in: Diab Obez 2025; 25(1): 42-46
Category: Reviews

Overview

High-sensitivity C-reactive protein (hsCRP), low-density lipoprotein (LDL) cholesterol and lipoprotein(a) levels contribute to 5-year and 10-year predictions of cardiovascular risk and represent distinct pathways for pharmacologic intervention. More information about the usefulness of these biomarkers for predicting cardiovascular risk over longer time in women is needed. Early-life intervention represents an important risk-reduction method. High-sensitivity CRP, LDL cholesterol and lipoprotein(a) serum levels at baseline in 27 939 initially healthy women were measured and they were subsequently followed for 30 years. The primary end-point was a first major adverse cardiovascular event, which was a composite of myocardial infarction, coronary revascularization, stroke or death from cardiovascular causes. The mean age of participants at baseline was 54.7 years. During the 30-year follow-up, 3 662 first cardiovascular events occured. Quintiles of increasing baseline levels of high-sensitivity CRP, LDL cholesterol and lipoprotein(a) all predicted 30-year risks. Covariable-adjusted hazard ratios for the primary end point in comparison of the top with the bottom quintile were 1.70 (95% CI was 1.52–1.90) for high sensitivity CRP, 1.36 (95% CI: 1.23–1.52) for LDL cholesterol and 1.33 (95% CI: 1.21–1.47) for lipoprotein(a). Findings for coronary heart disease and stroke appeared to be consistent with those for the primary end point. Each biomarker showed independent contributions to overall risk. The greatest spread for risk was obtained in models that incorporated all three biomarkers. A single combined measure of high-sensitivity CRP, LDL cholesterol and lipoprotein(a) serum levels among initially healthy women was predictive of incident cardiovascular events during a 30-year period.

Keywords:

lipoprotein(a) – Cholesterol – CV-events – high-sensitivity C-reactive protein (hsCRP) – lon-glasting trial with women– low-densitity lipoprotein (LDL-C)

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