{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T14:31:24Z","timestamp":1793802684561,"version":"4.6.1"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,10,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Higher plasma glycoprotein acetylation (GlycA) concentrations are associated with an increased risk for incident cardiovascular disease (CVD). We investigated the combined associations of GlycA with lipoprotein (a) (Lp[a]) and hs\u2010CRP (high\u2010sensitivity C\u2010reactive protein) with incident CVD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We followed 6676 MESA (Multi\u2010Ethnic Study of Atherosclerosis) participants, aged 45 to 84\u2009years, without baseline CVD. Lp(a), GlycA, and hs\u2010CRP were evaluated categorically using standard cut points (Lp[a]: 50\u2009mg\/dL; GlycA: 400\u2009\u03bcmol\/L; hs\u2010CRP: 2\u2009mg\/L). We used multivariable\u2010adjusted Cox hazards models to evaluate individual and combined associations of these 3 biomarkers with incident CVD, coronary heart disease, and stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Compared with those with low GlycA and low Lp(a) levels, an increase in both incident CVD and coronary heart disease risk was observed for those participants with high levels of either or both of these biomarkers. Risk was highest for those with both high GlycA and high Lp(a) levels (CVD hazard ratio [HR]=1.55 [95% CI: 1.15\u20132.10) and coronary heart disease (HR=1.92 [95% CI, 1.33\u20132.77). A similar pattern was not observed for individuals with high levels of both GlycA and hs\u2010CRP. Compared with participants with low levels of GlycA, Lp(a), and hs\u2010CRP, those with high levels of all 3 biomarkers had a 1.98\u2010fold higher CVD risk (95% CI, 1.39\u20132.82), a 2.23\u2010fold higher coronary heart disease risk (95% CI, 1.45\u20133.44), and a 2.51\u2010fold higher stroke risk (95% CI, 1.24\u20135.08).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Routine assessment of GlycA in addition to Lp(a) and hs\u2010CRP may help to identify individuals at particularly increased CVD risk who may benefit from more aggressive preventive therapies.<\/jats:p>\n                  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