{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:04:53Z","timestamp":1789535093628,"version":"build-2803163510"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,9,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Plasma levels of haptoglobin and IgA2 (immunoglobulin A2) have recently been associated with subclinical atherosclerosis in European cohorts. We sought to validate these findings in an American population and to determine whether these biomarkers predict all\u2010cause mortality or major cardiovascular adverse events beyond traditional risk scales (Framingham Risk Score) or vascular imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We analyzed 5328 asymptomatic US adults (mean age 69\u2009years, 56.9% women) from the BioImage study (A Clinical Study of Burden of Atherosclerotic Disease in an At\u2010Risk Population; NCT00738725). Subjects underwent carotid plaque burden assessment by ultrasound, coronary artery calcium by computed tomography, and baseline plasma haptoglobin and IgA2 levels measurement by immunoturbidimetry. The end point was a composite of major cardiovascular adverse events and all\u2010cause death during follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Haptoglobin and IgA2 correlated significantly with carotid plaque burden and coronary artery calcium, independent of Framingham Risk Score. After a median follow\u2010up of 4.6\u2009years, 466 participants (8.8%) experienced the composite outcome. Haptoglobin and IgA2 independently predicted the outcome, and associations remained significant after further adjustment for carotid plaque burden or coronary artery calcium. Similar results were observed for predictive capacity of high\u2010sensitivity C\u2010reactive protein. Individuals with high levels of all biomarkers (above the median) had a 2\u2010fold higher event rate compared with those with low levels. Combined biomarker assessment, albeit modestly, significantly improved risk prediction beyond Framingham Risk Score and imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Haptoglobin and IgA2 predict the composite outcome of major cardiovascular adverse events and all\u2010cause death, independently to Framingham Risk Score, in asymptomatic American adults. Their measurement, alone or in combination with imaging, may enhance cardiovascular risk stratification in primary prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.048286","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T14:55:00Z","timestamp":1788965700000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Haptoglobin and Immunoglobulin A2 Predict Cardiovascular Risk in Asymptomatic Subjects: The BioImage Study"],"prefix":"10.1161","volume":"15","author":[{"given":"Ana","family":"Garc\u00eda\u2010\u00c1lvarez","sequence":"first","affiliation":[{"name":"Centro Nacional de Investigaciones Cardiovasculares Carlos III","place":["Madrid, Spain"]},{"name":"Hospital Cl\u00ednic Barcelona and August Pi i Sunyer Biomedical Research Institute","place":["Barcelona, Spain"]},{"name":"Universitat de Barcelona","place":["Barcelona, Spain"]},{"name":"CIBER de 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