Triple Biomarker Test Reveals 3x Higher Heart Attack Risk

New research presented at the American Heart Association's Scientific Sessions 2025 reveals that combining three specific blood tests could revolutionize how we identify people at highest risk for heart attacks. The study, led by Dr. Richard Kazibwe of Wake Forest University School of Medicine, analyzed data from over 300,000 participants in the UK Biobank and found that adults with elevated levels of all three biomarkers—lipoprotein(a), remnant cholesterol, and high-sensitivity C-reactive protein (hsCRP)—had nearly triple the risk of heart attack compared to those with normal levels. The research demonstrates a clear stepwise pattern: one elevated biomarker meant 45% higher risk, two biomarkers doubled the risk, and all three biomarkers together nearly tripled the danger. These tests examine different pathways to cardiovascular disease—genetics through lipoprotein(a), cholesterol metabolism through remnant cholesterol, and inflammation through hsCRP—creating a comprehensive picture when combined.

The study's findings suggest that these simple blood tests, which are already available at most labs, could help healthcare professionals identify high-risk individuals much earlier and provide more personalized prevention strategies. As Dr. Kazibwe explained, "These biomarkers work together like pieces of a puzzle. One piece cannot show the full picture, yet when combined, we can see a much clearer and more complete depiction of heart attack risks." The research highlights that even when traditional risk factors like blood pressure and standard cholesterol levels appear normal, these additional tests can uncover hidden inflammation, genetic predispositions, and cholesterol abnormalities that standard screening might miss. This approach could be particularly valuable for people with family history of heart disease, Type 2 diabetes, or other cardiovascular risk factors who might benefit from discussing these tests with their healthcare team.

While the study has limitations—being observational and primarily involving white participants from the UK Biobank—it represents an important step toward more personalized cardiovascular care. American Heart Association volunteer expert Dr. Pamela Morris noted that these biomarkers can aid in clinical decision making, particularly for patients where treatment decisions are uncertain. The research supports recommendations that consideration of risk enhancers including lipoprotein(a), hsCRP and remnant cholesterol can play an important role in personalizing risk estimates beyond traditional assessment tools. As cardiovascular disease remains the leading cause of death worldwide, this combined biomarker approach offers promise for earlier detection and more targeted prevention strategies that could ultimately save lives.