Combined Associations of Glycoprotein Acetylation With Lipoprotein (a) and hs-CRP (High-Sensitivity C-Reactive Protein) on Risk of Cardiovascular Disease in MESA.
Garg P, Guan W, et al. • Journal of the American Heart Association • 2026
Participants in MESA with high levels of GlycA, Lp(a), and hs-CRP together had about 2-fold higher CVD risk, 2.2-fold higher CHD risk, and 2.5-fold higher stroke risk than those with low levels of all three, suggesting that routine GlycA assessment alongside Lp(a) and hs-CRP may help identify individuals at particularly increased CVD risk.
Key Findings
Results
Participants with high levels of both GlycA and Lp(a) had the highest risk of incident CVD and CHD among the GlycA/Lp(a) combinations.
Cohort: 6676 MESA participants aged 45 to 84 years without baseline CVD.
Compared with low GlycA and low Lp(a), high levels of both had a CVD HR of 1.55 (95% CI, 1.15-2.10).
For coronary heart disease, the HR for high GlycA plus high Lp(a) was 1.92 (95% CI, 1.33-2.77).
Cox models were multivariable-adjusted, with cut points of Lp(a) 50 mg/dL and GlycA 400 μmol/L.
Results
High levels of either GlycA or Lp(a) alone were also associated with increased risk of incident CVD and CHD compared with low levels of both.
The abstract reports increased CVD and CHD risk for participants with high levels of either or both biomarkers relative to low GlycA and low Lp(a).
Risk was highest in the group with both biomarkers high.
Results
A similar pattern of additive risk was not observed for individuals with high levels of both GlycA and hs-CRP.
hs-CRP was categorized at 2 mg/L and GlycA at 400 μmol/L.
The abstract states the pattern seen for GlycA with Lp(a) was not seen for GlycA with hs-CRP.
Results
Participants with high levels of all three biomarkers (GlycA, Lp(a), hs-CRP) had substantially higher risk of CVD, CHD, and stroke than those with low levels of all three.
CVD HR was 1.98 (95% CI, 1.39-2.82).
CHD HR was 2.23 (95% CI, 1.45-3.44).
Stroke HR was 2.51 (95% CI, 1.24-5.08).
Reference group was low GlycA, low Lp(a), and low hs-CRP.
Conclusions
The authors conclude that routine assessment of GlycA in addition to Lp(a) and hs-CRP may help identify individuals at particularly increased CVD risk who may benefit from more aggressive preventive therapies.
Higher plasma GlycA is previously associated with increased incident CVD risk.
The study examined individual and combined associations of the three biomarkers with CVD, CHD, and stroke.
What This Means
This study followed 6,676 middle-aged and older adults from a large U.S. study (MESA) who did not have heart disease at the start. Researchers looked at three blood markers: lipoprotein(a), a cholesterol-carrying particle largely determined by genetics; hs-CRP, a common marker of inflammation; and GlycA, another inflammation-related marker. They tracked who later developed cardiovascular disease, coronary heart disease, or stroke.
People with high levels of both GlycA and lipoprotein(a) had higher risk of cardiovascular disease (about 55% higher) and coronary heart disease (about 92% higher) than people with low levels of both. This extra risk was not seen in the same way when GlycA and hs-CRP were both high. People with high levels of all three markers had roughly double the risk of cardiovascular disease, more than double the risk of coronary heart disease, and about 2.5 times the risk of stroke compared with those with low levels of all three.
This research suggests that measuring GlycA alongside lipoprotein(a) and hs-CRP might help identify people at especially high cardiovascular risk. The findings come from an observational study, which shows associations rather than proving cause, and the authors suggest such people could potentially benefit from more intensive preventive care.
Garg P, Guan W, Nomura S, Otvos J, Connelly M, Bhatia H, et al.. (2026). Combined Associations of Glycoprotein Acetylation With Lipoprotein (a) and hs-CRP (High-Sensitivity C-Reactive Protein) on Risk of Cardiovascular Disease in MESA.. Journal of the American Heart Association. https://doi.org/10.1161/JAHA.125.048493