{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:54:02Z","timestamp":1790927642565,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>The associations of two\u2010point change patterns of low\u2010density lipoprotein cholesterol (LDL\u2010C) and high\u2010sensitivity C\u2010reactive protein (hs\u2010CRP) with major adverse cardiovascular events (MACE) remain underexplored, particularly in Chinese populations. This study aimed to identify LDL\u2010C and hs\u2010CRP change patterns and examine their associations with incident MACE in middle\u2010aged and older Chinese adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort study included 9597 participants aged 45 years or older and free of cardiovascular disease at baseline from the China Health and Retirement Longitudinal Study. Among them, 6405 participants with biomarker measurements available in both 2011 and 2015 were included in the two\u2010point change pattern analysis. Group\u2010based trajectory modeling was used to identify two\u2010point change pattern groups for LDL\u2010C and log\u2010transformed hs\u2010CRP. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), with adjustment for potential confounders including lipid\u2010lowering medication use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over a median follow\u2010up of 9.00 years, 2248 participants (23.4%) developed MACE. Higher baseline hs\u2010CRP levels were associated with increased MACE risk, with a significant association observed for the fourth quintile versus the first quintile (HR\u2009=\u20091.19, 95% CI: 1.04\u20131.36). In the two\u2010point change pattern analysis, the\n                      <jats:italic>High baseline, decreasing<\/jats:italic>\n                      log\u2010hsCRP group showed a lower HR estimate for MACE than the\n                      <jats:italic>Low baseline, increasing<\/jats:italic>\n                      group, although this association did not reach conventional statistical significance (HR\u2009=\u20090.82, 95% CI: 0.67\u20131.01,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.06). Neither baseline LDL\u2010C levels nor LDL\u2010C two\u2010point change pattern groups were significantly associated with MACE after full multivariable adjustment. Having one elevated biomarker (LDL\u2010C Q5 or hs\u2010CRP Q5) was associated with increased MACE risk (HR\u2009=\u20091.11, 95% CI: 1.02\u20131.21) compared with having neither elevated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Baseline hs\u2010CRP showed a stronger association with MACE than LDL\u2010C after comprehensive adjustment. A decrease in hs\u2010CRP from a high baseline level was associated with a lower HR estimate for MACE, although this finding was not statistically significant. These results support the relevance of inflammatory status in cardiovascular risk assessment, while LDL\u2010C monitoring remains a cornerstone of cardiovascular prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.72842","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T06:05:23Z","timestamp":1786082723000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Two\u2010Point Change Patterns of LDL\u2010Cholesterol and hs\u2010CRP and Risk of Major Adverse Cardiovascular Events in Middle\u2010Aged and Older Chinese Adults: A Prospective Cohort Study"],"prefix":"10.1002","volume":"9","author":[{"given":"Jiayin","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery Tianjin Medical University General Hospital Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery Tianjin Medical University General Hospital Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zongwei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery Tianjin Medical University General Hospital Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhian","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery Tianjin Medical University General Hospital Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9266-9064","authenticated-orcid":false,"given":"Yujun","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Tianjin Key Laboratory of Inflammation Biology Key Laboratory of Immune Microenvironment and Disease (Ministry of Education), School of Basic Medical Sciences, Tianjin Medical University Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9074-6452","authenticated-orcid":false,"given":"Xiangchen","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery Tianjin Medical University General Hospital Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2024.1408487"},{"key":"e_1_2_13_3_1","unstructured":"Center For Cardiovascular Diseases The Writing Committee of The Report on Cardiovascular Health and Diseases in China 2023.An Updated Summary. 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