Filippo Cademartiri: 3 Biomarkers Are Better Than 1: Refining ASCVD Risk in MESA
Filippo Cademartiri, Consultant Advanced Cardiovascular Imaging at UPMC Salvator Mundi International Hospital, shared on LinkedIn:
”Three biomarkers are better than one: refining ASCVD risk in MESA
Traditional risk assessment often treats biomarkers in isolation.
This large analysis from the Multi-Ethnic Study of Atherosclerosis (MESA) shows why that approach may miss the people at highest cardiovascular risk.
What was studied?
Researchers evaluated the individual and combined effects of:
Lipoprotein(a) [Lp(a)]
High-sensitivity CRP (hs-CRP)
Total homocysteine (tHcy)
on coronary heart disease (CHD) and stroke over ~16 years of follow-up in >6,600 asymptomatic adults.
Key findings
Alone, biomarkers showed modest or inconsistent associations.
Risk rose sharply only when biomarkers were elevated together.
Individuals with all three elevated had:
~2× higher risk of CHD
~3× higher risk of stroke
In contrast, having just one elevated marker often did not meaningfully increase risk after adjustment.
Why this matters
This study highlights a core limitation of single-marker thinking:
ASCVD risk is multidimensional
Inflammation, thrombosis, and atherogenesis interact
“Average” risk estimates can obscure high-risk biological phenotypes
Notably, homocysteine—not currently a guideline risk enhancer—emerged as a powerful amplifier of risk when combined with inflammation and Lp(a).
Important nuance
Adding these biomarkers only modestly improved population-level prediction metrics (C-statistics). But for individual risk stratification, the signal is clinically meaningful.
Take-home message
ASCVD risk is not additive—it’s synergistic.
Looking at biomarker combinations, rather than single values, may better identify who truly carries residual cardiovascular risk.
Precision prevention beats one-number medicine.”
Read the full article here.
Article: Lipoprotein(a), high-sensitivity c-reactive protein, homocysteine and cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis
Authors: Sarah O. Nomura, Harpreet S. Bhatia, Parveen K. Garg, Amy B. Karger, Weihua Guan, Jing Cao, Michael D. Shapiro, Michael Y. Tsai
Stay updated on all scientific advances with Hemostasis Today.
-
Jun 16, 2026, 17:36Suhasini Sil: Mitigating Grade III Plateletpheresis Reactions – A Prospective Evaluation
-
Jun 16, 2026, 17:32Presenting Pivotal Phase 3 Sickle Cell Data at EHA 2026- Agios Pharmaceuticals
-
Jun 16, 2026, 16:17Megan Lynch: Thrilled to Join AstraZeneca
-
Jun 16, 2026, 16:00Denise M: Two Partners, One Mission – Securing the Future of Blood
-
Jun 16, 2026, 15:4910 Posts Not To Miss From EHA 2026
-
Jun 16, 2026, 15:48Yan Leyfman: Can a Blood Test Reveal which Cells in Your Body are Aging Fastest?
-
Jun 16, 2026, 15:24Hiteshi K.C. Chauhan: Oral Anticoagulant Reversal in Major Bleeding and Urgent Surgery
-
Jun 16, 2026, 14:50Abdulrahman Nasiri: Honored to Share our Research Contributions at the EHA 2026
-
Jun 16, 2026, 14:49An Overview of Bernard–Soulier Syndrome – ICHCC