Evidence mapPaperPMID 40320753Full record

ArticleEuropean heart journal2025

Low-density lipoprotein cholesterol, lipoprotein(a) and high-sensitivity C-reactive protein are independent predictors of cardiovascular events.

Marcello Ricardo Paulista Markus, Till Ittermann, Joany Mariño Coronado, Sabine Schipf, Martin Bahls, Stephanie Könemann, Bishwas Chamling, Henry Völzke, Nágila Raquel Teixeira Damasceno, Raul Dias Santos and 4 more

Erratum issuedAbstract read
In one paragraph

Article in European heart journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
  4. Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Article
  17. Article
  18. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Marcello Ricardo Paulista MarkusDepartment of Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, Greifswald 17475, Germany.ORCID 0000-0002-6234-4955
Till IttermannGerman Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.ORCID 0000-0002-0154-7353
Joany Mariño CoronadoDepartment of Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, Greifswald 17475, Germany.ORCID 0000-0002-4657-3758
Sabine SchipfGerman Center for Diabetes Research (DZD), Partner Site Greifswald, Greifswald, Germany.ORCID 0000-0002-2700-5317
Martin BahlsDepartment of Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, Greifswald 17475, Germany.ORCID 0000-0002-2016-5852
Stephanie KönemannDepartment of Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, Greifswald 17475, Germany.ORCID 0000-0002-3396-2906
Bishwas ChamlingDepartment of Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, Greifswald 17475, Germany.ORCID 0000-0003-3101-343X
Henry VölzkeGerman Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.ORCID 0000-0001-7003-399X
Nágila Raquel Teixeira DamascenoNutrition Department, School of Public Health, University of São Paulo, São Paulo, Brazil.ORCID 0000-0002-9332-7816
Raul Dias SantosAcademic Research Organization, Hospital Israelita Albert Einstein, São Paulo, Brazil.ORCID 0000-0002-9860-6582
Stephan Burkhard FelixDepartment of Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, Greifswald 17475, Germany.ORCID 0000-0002-0744-091X
Christian TemplinDepartment of Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, Greifswald 17475, Germany.ORCID 0000-0003-0287-4193
Elisabeth Steinhagen-ThiessenLipid Clinic at the Interdisciplinary Metabolism Center, Charité-University Medicine Berlin, Berlin, Germany.ORCID 0000-0003-3056-3317
Marcus DörrDepartment of Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, Greifswald 17475, Germany.ORCID 0000-0001-7471-475X

Funding

British Heart FoundationDepartment of HealthMedical Research CouncilNorthwest Regional Development AgencyScottish governmentScottish GovernmentUniversity Medicine GreifswaldWellcome TrustWelsh assembly government;
6 · The paper itself

Abstract

BACKGROUND AND

aimsAssociations of hyperlipidaemia and inflammation with the risk for incident major adverse cardiovascular events (MACEs) were analysed in individuals with and without cholesterol-lowering medication therapy.

methodsData from 322,922 participants (55.9% women) aged 38 to 73 years from the UK Biobank were included. Longitudinal associations of low-density lipoprotein cholesterol (LDL-C), lipoprotein(a) [Lp(a)], and high-sensitivity C-reactive protein (Hs-CRP), both individually and in combination, were analysed with the risk for incident MACEs using Cox regression models, stratified by cholesterol-lowering medication use.

resultsDuring a median follow-up of 13.7 years, 31,295 (9.69%) participants had incident MACEs. The incidence was 8.32% in non-users and 18.6% in users of cholesterol-lowering medication. Higher LDL-C levels were associated with the highest risk for MACEs, followed by Lp(a) and Hs-CRP. One higher standard deviation in LDL-C, Lp(a), and Hs-CRP was associated with a 13%, 8%, and 6% greater risk for MACEs in non-users and 11%, 7%, and 6% in cholesterol-lowering medication users, respectively. When combined, LDL-C, Lp(a), and Hs-CRP demonstrated a synergistic effect. Compared with individuals with all three biomarkers at or below the 75th percentile, those with all three biomarkers above the 75th percentile had a 77% higher risk for incident MACEs among non-users and a 58% higher risk among those on cholesterol-lowering medications.

conclusionsHyperlipidaemia and inflammation independently and synergistically contribute to an increased risk for incident cardiovascular events. The magnitude of risk is more closely related to serum biomarker concentrations than to the use or not of cholesterol-lowering medications.

Indexed as

Cardiovascular DiseasesCholesterol, LDLC-Reactive ProteinLipoprotein(a)AdultAgedAnticholesteremic AgentsBiomarkersFemaleHumansMaleMiddle AgedAnticholesteremic AgentsBiomarkersCholesterol, LDLC-Reactive ProteinLipoprotein(a)Cardiovascular mortalityCholesterol-lowering medicationHigh-sensitivity C-reactive proteinHyperlipidemiaLipoprotein(a)Low-density lipoprotein cholesterolResidual risk

Identifiers

PMID40320753
PMCPMC12517743

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.