Journal of the American College of Cardiology最新文献

Background: Coronary artery disease (CAD) polygenic risk score (PRS), low-density-lipoprotein cholesterol (LDL-C), lipoprotein(a) (Lp(a)), and high-sensitivity C-reactive protein (hsCRP) are biomarkers that predict CAD. It is unclear whether integrating genomics with lipid and inflammatory biomarkers could complement traditional risk scores in identifying people at risk of CAD.

Objectives: This study assesses the predictive value of CAD PRS, LDL-C, Lp(a), and hsCRP for incident CAD across different age and sex groups.

Methods: Participants (n = 215,695) from the UK Biobank aged 40 to 69 years with baseline CAD PRS, LDL-C, Lp(a), and hsCRP values were followed for 12 years to assess the incidence of CAD. We evaluated a multivariable-adjusted Cox model that included all 4 biomarkers, net reclassification index, C-statistics, and population attributable risk across different age and sex groups.

Results: Over a 12-year follow-up, 4,721 men and 2,425 women developed CAD. The HRs for incident CAD associated with each biomarker elevation were 1.79 (95% CI: 1.70-1.89) for CAD PRS, 1.60 (95% CI: 1.48-1.66) for LDL-C, 1.20 (95% CI: 1.12-1.29) for Lp(a), and 1.64 (95% CI: 1.57-1.72) for hsCRP. CAD PRS demonstrated a stronger association in men (HR per SD: 1.49; 95% CI: 1.45-1.54) than women (HR per SD: 1.37; 95% CI: 1.31-1.44; P-interaction ≤ 0.001). All biomarkers conferred greater HRs at younger ages (P < 0.0001). Individuals with all biomarkers elevated had a 4.65-fold increased risk of CAD compared with those with no elevated biomarkers. A combined 4-biomarker model had a higher C-statistic of 0.753 compared with the pooled cohort equations (C-statistic of 0.740). The C-statistic of the combined 4-biomarker model was also higher in younger individuals in both sexes and yielded a 32.0% continuous net reclassification index when compared with the pooled cohort equations.

Conclusions: CAD PRS, LDL-C, hsCRP, and Lp(a) show independent age- and sex-specific associations with CAD. Measuring all 4 biomarkers may improve midlife CAD risk prediction for both male and female patients.

Background: Cardiovascular disease remains the leading cause of morbidity and mortality in the United States. JACC Cardiovascular Statistics 2026 reports the most up-to-date data on cardiovascular health in the United States. The report covers major cardiovascular risk factors (hypertension, diabetes, obesity, cholesterol, and cigarette smoking) and conditions that collectively account for most cardiovascular deaths and disability: coronary heart disease, acute myocardial infarction, heart failure, peripheral artery disease, and stroke.

Objectives: JACC Cardiovascular Statistics was developed to provide a clear, comprehensive, and accessible snapshot of cardiovascular health in the United States. An annual synthesis of contemporary cardiovascular statistics is needed to inform patients, clinicians, researchers, public health professionals, policymakers, and the public.

Methods: This report synthesizes data from multiple national sources, including population-based surveys, clinical registries, administrative datasets, and vital statistics. For each risk factor and condition, we evaluated trends in disease epidemiology, quality of care, and morbidity and mortality. Data are presented overall and, where available, stratified by age, sex, race and ethnicity, socioeconomic status, and geography. Findings are presented using a standardized, visually accessible framework.

Results: Cardiovascular risk factors-hypertension, diabetes, obesity, cholesterol, and cigarette smoking-remain prevalent among U.S. adults, with persistent gaps in prevention and treatment. Across cardiovascular conditions-coronary heart disease, acute myocardial infarction, heart failure, peripheral artery disease, and stroke-long-term gains in mortality are slowing or reversing, with ongoing gaps in quality of care and persistent health disparities.

Conclusions: JACC Cardiovascular Statistics 2026 provides a comprehensive snapshot of cardiovascular health in the United States, serving as an annual benchmark to guide clinical practice, inform health policy, and promote accountability in efforts to improve cardiovascular health and outcomes for all.