# hsCRP en lipoproteïne(a) versterken risicoprofilering bij hart- en vaatziekten

*geplaatst 2026-11-06 · Preventie · Atherosclerosis · doi 10.1016/j.atherosclerosis.2026.121916 · https://hartvaat.nl/2026/11/01/hscrp-en-lipoproteine-a-versterken-risicoprofilering-bij-hart-en-vaatziekten/*

Een grote cohortstudie in de UK Biobank onderzocht de prognostische waarde van hsCRP en lipoproteïne(a) [Lp(a)] voor MACE over verschillende basale risicogroepen heen. hsCRP was in alle subgroepen en beide geslachten consistent geassocieerd met een verhoogd MACE-risico, terwijl Lp(a) alleen in vrouwen over alle groepen heen voorspellend was en bij mannen uitsluitend in de primaire preventie. Deze bevindingen ondersteunen het selectief meten van beide biomarkers om de risicostratificatie naast SCORE2 te verfijnen, hoewel interventiestudies nog nodig zijn om de klinische toepassing te valideren.

## English: Inflammation and lipoprotein(a) as predictors of cardiovascular events across baseline risk levels - results from the UK Biobank.

A large UK Biobank cohort study evaluated the prognostic value of hsCRP and lipoprotein(a) [Lp(a)] for major adverse cardiovascular events across varying baseline risk strata. hsCRP consistently predicted MACE across all risk groups and both sexes, whereas Lp(a) showed a sex-specific pattern: it was independently associated with events in women across all groups, but only in men undergoing primary prevention. These findings support the selective use of hsCRP and Lp(a) to refine cardiovascular risk stratification beyond traditional models like SCORE2, though randomised trials are required to determine whether biomarker-guided interventions improve outcomes.

## Abstract (original, from the publication)

AIMS: To determine how high-sensitivity C-reactive protein (hsCRP) and lipoprotein(a) [Lp(a)] predict major adverse cardiovascular events (MACE) across the spectrum of baseline cardiovascular risk. METHODS: UK Biobank participants were grouped according to baseline cardiovascular risk. The primary endpoint was first MACE (myocardial infarction, ischaemic stroke, cardiovascular death). Cox models estimated sex-specific hazard ratios (HR) based on standardised (per standard deviation [SD]) and categorised (quartile) biomarker levels, adjusted for components of the Systematic COronary Risk Evaluation (SCORE) 2 model and the other biomarker. RESULTS: Median follow-up duration was 15.2 years. There were 241010 low-risk, 74179 high-risk, 25512 very high-risk, 60177 treated (lipid-lowering therapy) and 15720 secondary prevention participants included. Median calculated 10-year cardiovascular risk in the low-, high- and very high-risk subgroups was 1.8%, 6.3% and 10.4% respectively. Continuous hsCRP levels were directly associated with MACE in both sexes across all subgroups (p < 0.001). The strongest quartile effect was in the secondary prevention cohorts (Q4 vs Q1: HR +79% men, +81% women; p < 0.001). HsCRP associated with each MACE component. Lp(a) predicted MACE independently but heterogeneously: in women associations were consistent across subgroups (per-SD HR 1.06-1.11; p ≤ 0.005), whereas in men Lp(a) predicted MACE only in primary prevention subgroups (per-SD HR 1.11-1.15; p < 0.001) but not in secondary prevention (p = 0.65). In primary prevention subgroups, Lp(a) associations were driven largely by myocardial infarction (p < 0.001). CONCLUSION: HsCRP and Lp(a) provide prognostic information beyond traditional risk factors used in SCORE2. These findings endorse selective measurement of hsCRP and Lp(a) to refine risk stratification, though randomised trials are needed to validate biomarker-directed interventions.

Auteurs: Bradley Tucker, Kwok Leung Ong, Thomas Payne, Kristy P Robledo, Anthony Keech, Sanjay Patel

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Bron: Atherosclerosis, https://doi.org/10.1016/j.atherosclerosis.2026.121916. Bijgewerkt 2026-10-30T02:22:32Z. 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.