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REFLECTIONS
Dyslipidaemia
Dyslipidaemia Global Newsletter #10 2025

Concentrations of almost all biomarkers increased proportionally to the number of CVRFs. Analysis showed that elevated TGs
and hsCRP were significantly associated with increased CHD risk even among individuals without traditional risk factors. Among
individuals without CVRFs at baseline, increased TG concentration (defined as ≥1.70 mmol/L or 150 mg/dL) was strongly
Dyslipidaemia
associated with future CHD events. The fully adjusted subdistribution hazard ratio (sHR) was 1.66 (95% CI: 1.29–2.15). The
magnitude of the TG association with CHD risk decreased as the number of CVRFs increased. Elevated hsCRP levels (≥2 mg/L)
were associated with CHD events in individuals with zero CVRFs, with a fully adjusted sHR of 1.39 (95% CI: 1.02–1.90). Therefore,
even in the absence of the five major traditional risk factors,
22.1% of CVRF-free individuals demonstrated an increased
inflammatory burden (hsCRP ≥2 mg/L). CLINICAL PEARLS FROM THE FACULTY

The authors propose that TRLs, through remnant-C, may
drive atherogenesis independently of LDL-C, while low-grade
inflammation indicated by elevated hsCRP promotes vascular
injury and plaque instability. In contrast, cystatin C, NT-proBNP,
and hs-TnI showed weaker or inconsistent associations in the
low-risk group.

These findings have important implications for prevention and
risk assessment, suggesting that routine evaluation of TGs and
hsCRP could improve identification of individuals at risk who may
be missed by traditional algorithms. The results highlight that WATCH
absence of conventional risk factors does not equate to zero risk PROF. CRISTINA GAVINA DISCUSS
and support expanding prevention strategies beyond the standard THE CLINICAL RELEVANCE OF THIS
10-year estimates by incorporating biomarker-based profiling to ARTICLE.
capture subclinical metabolic and inflammatory pathways. Early
detection of elevated TGs or hsCRP, combined with healthy
lifestyle practices and emerging therapies targeting remnant CLICK HERE
lipoproteins and inflammation, may help mitigate the burden of FOR THE LINK TO FULL ARTICLE
residual CV risk in the general population.

ARTICLES OF INTEREST

REVIEWS

1. The Brussels international declaration on lipoprotein(a) testing and management. Kronenberg F, et al Atherosclerosis.
2025 Jul;406:119218.

2. Understanding MASLD - from molecular pathogenesis to cardiovascular risk: A concise review for the clinical
cardiologist. Ratti C, et al. Atherosclerosis. 2025 Oct;409:120495.

3. Multidisciplinary teams in clinical lipidology and cardiometabolic care: A National Lipid Association expert clinical
review. Cheeley MK, et al. J Clin Lipidol. 2025 Jul-Aug;19(4):737-747.

EPIDEMIOLOGY AND GENETICS

4. Cumulative exposure to atherogenic lipoprotein particles in young adults and subsequent incident atherosclerotic
cardiovascular disease. Zheutlin AR, et al. Eur Heart J. 2025 Jul 4:ehaf472. doi: 10.1093/eurheartj/ehaf472. Online ahead
of print.

5. Causal relevance of Lp(a) for coronary heart disease and stroke types in East Asian and European ancestry
populations: A mendelian randomization study. Clarke R, et al. Circulation. 2025 Jun 17;151(24):1699-1711.

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