A new analysis from the American Heart Association’s Scientific Sessions 2025 suggests that a simple combination of three blood tests could help doctors identify people at the highest risk for heart attacks—before symptoms appear.
The study focused on three biomarkers: lipoprotein(a), remnant cholesterol, and high-sensitivity C-reactive protein (hsCRP).
Each test measures something different related to heart health. Lipoprotein(a), or Lp(a), is a type of inherited cholesterol that can cause plaque to build up in arteries.
Remnant cholesterol includes harmful fat particles that traditional cholesterol tests might miss but still clog arteries. hsCRP shows inflammation in the body, which can stress the heart and damage arteries.
Individually, each marker offers a small hint of heart attack risk. But when combined, the risk increases dramatically. “When all three biomarkers were elevated, the risk of heart attack was nearly three times higher,” said Dr. Richard Kazibwe of Wake Forest University School of Medicine, who led the study.
Using data from more than 300,000 people in the UK Biobank, the researchers tracked heart attacks over a median of 15 years. None of the participants had heart disease at the beginning of the study.
They found that people with one elevated biomarker had a 45% higher risk of heart attack. Those with two elevated biomarkers had more than double the risk. People with all three biomarkers in the top 20% had almost triple the risk.
This “stepwise” pattern strongly supports the idea that these tests offer a clearer, more complete picture of someone’s risk. Dr. Kazibwe believes this approach could improve how health professionals decide who needs early treatment or lifestyle changes.
While these tests are not yet part of routine checkups, they are more accessible than many think. hsCRP and Lp(a) tests are available by request in most labs. Remnant cholesterol can be calculated using results from a standard cholesterol panel by subtracting LDL and HDL from total cholesterol.
Experts believe the findings could lead to more personalized prevention plans. “Even if someone’s cholesterol or blood pressure appears normal, these tests can uncover hidden risks,” said Dr. Kazibwe.
They could guide doctors to start cholesterol-lowering or blood pressure medications earlier, or strongly recommend lifestyle changes before serious heart problems develop.
The study also fits with the 2025 AHA/ACC Guidelines, which support using risk-enhancing markers like Lp(a), hsCRP, and remnant cholesterol when making heart health decisions. According to Dr. Pamela Morris, a cardiology expert not involved in the research, the results show these tests can help resolve uncertainty in borderline cases.
The researchers point out some limitations. Since it was an observational study, it cannot prove the biomarkers directly caused the heart attacks. And since nearly all participants in the UK Biobank were white, more diverse studies are needed.
Still, the findings are promising. They show how combining tools like genetic scores, calcium scans, and now biomarker panels can create a more complete picture of heart health. For those with a family history of heart disease, diabetes, or other risk factors, talking to a doctor about these tests could be a smart step toward preventing a heart attack.
If you care about heart health, please read studies about how eating eggs can help reduce heart disease risk, and Vitamin K2 could help reduce heart disease risk.
For more information about heart health, please see recent studies about how to remove plaques that cause heart attacks, and results showing a new way to prevent heart attacks, strokes.
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