Inflammatory biomarkers continue to be explored for their potential role in cardiovascular risk prediction beyond conventional clinical scoring systems. In a prospective observational cohort study published in the European Journal of Preventive Cardiology, investigators evaluated whether circulating soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) levels were associated with future cardiovascular disease (CVD) events in adults without baseline CVD.

The analysis included 9,097 participants free of cardiovascular disease at enrollment between 2008 and 2012. Participants had a mean age of 59.6±6.3 years, and 39% were women. Baseline plasma sTREM-1 concentrations were measured using a centralized protocol optimized for Meso Scale Discovery technology. Incident cardiovascular outcomes included adjudicated coronary heart disease, stroke, heart failure, and peripheral artery disease events.

During a median follow-up of 10.1 years (IQR 9.2-12.0), 444 participants experienced 479 cardiovascular events. Investigators assessed the association between sTREM-1 concentrations and incident CVD using multivariable Cox proportional hazards models and evaluated the incremental predictive performance of adding sTREM-1 to established risk scores.

Findings

• Median baseline sTREM-1 concentration was 193.41 pg/mL (IQR 158.13-241.54).
• Compared with participants with sTREM-1 concentrations <200 pg/mL, those with levels between 200 and 290 pg/mL had higher CVD risk (HR 4.25; 95% CI 3.20-5.63).
• Participants with sTREM-1 concentrations >290 pg/mL showed substantially higher incident CVD risk (HR 10.40; 95% CI 7.72-14.02).
• Improvement in risk classification was also observed after adding sTREM-1 (categorical net reclassification improvement 0.34; 95% CI 0.28-0.40).

The findings suggest that elevated circulating sTREM-1 levels were independently associated with higher risk of incident cardiovascular disease in adults without baseline CVD.