{"id":"8a581cf0210c","type":"article","url":"https://hartvaat.nl/2024/12/05/inflammatie-cholesterol-lp-a-en-30-jaars-cv-uitkomsten-bij-vrouwen/","title":"Inflammatie, cholesterol, Lp(a) en 30-jaars CV-uitkomsten bij vrouwen","title_en":"Inflammation, Cholesterol, Lipoprotein(a), and 30-Year Cardiovascular Outcomes in Women.","category":"cholesterol","category_label":"Cholesterol","professions":["cardioloog","huisarts","internist"],"tags":["cetp-remmers","dyslipidemie","ezetimibe","familiaire-hypercholesterolemie-screening","hdl-cholesterol","hs-crp","inflammatie","ldl-cholesterol","lipide-aferese","lipidenverlaging","lipoproteïne-a","lipoproteïne-a-therapeutisch-doel","niet-statine-therapie","pelacarsen","plaquekarakterisatie","statines","vrouwen"],"journal":"The New England journal of medicine","doi":"10.1056/NEJMoa2405182","source_url":"https://doi.org/10.1056/NEJMoa2405182","authors":["Paul M Ridker","M Vinayaga Moorthy","Nancy R Cook","Nader Rifai","I-Min Lee","Julie E Buring"],"significance":7,"published":"2024-12-05","source_date":"2024-12-05","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lp-a-verhoogd/","https://hartvaat.nl/kennis/lipiden/lipidenmedicatie-bij-ckd/"],"congress":"","summary_en":"This 30-year follow-up study in women demonstrated that hsCRP, LDL cholesterol, and Lp(a) independently predict cardiovascular events over three decades, establishing that these biomarkers provide meaningful long-term risk prediction well beyond the standard 10-year horizon.","created":"2026-07-03T10:31:21Z","updated":"2026-07-03T13:30:22Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Dertigjaars follow-up studie bij vrouwen toonde dat hsCRP, LDL-cholesterol en Lp(a) onafhankelijk langetermijn CV-events voorspellen. De drie risicofactoren verklaren complementaire risicopaden en vereisen geïntegreerde beoordeling.","abstract_original":"BACKGROUND: High-sensitivity C-reactive protein (CRP), 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 periods of time in women is needed because early-life intervention represents an important risk-reduction method. METHODS: We measured high-sensitivity CRP, LDL cholesterol, and lipoprotein(a) levels at baseline in 27,939 initially healthy U.S. women who 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. We calculated the adjusted hazard ratios and 95% confidence intervals across quintiles of each biomarker, along with 30-year cumulative incidence curves adjusted for age and competing risks. RESULTS: The mean age of the participants at baseline was 54.7 years. During the 30-year follow-up, 3662 first major cardiovascular events occurred. 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 a comparison of the top with the bottom quintile were 1.70 (95% confidence interval [CI], 1.52 to 1.90) for high-sensitivity CRP, 1.36 (95% CI, 1.23 to 1.52) for LDL cholesterol, and 1.33 (95% CI, 1.21 to 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. CONCLUSIONS: A single combined measure of high-sensitivity CRP, LDL cholesterol, and lipoprotein(a) levels among initially healthy U.S. women was predictive of incident cardiovascular events during a 30-year period. These data support efforts to extend strategies for the primary prevention of atherosclerotic events beyond traditional 10-year estimates of risk. (Funded by the National Institutes of Health; Women's Health Study ClinicalTrials.gov number, NCT00000479.)."}