Prevalence of high inflammatory risk (hsCRP ≥2 mg/L) in European patients with atherosclerotic cardiovascular disease with/without chronic kidney disease: sub-analysis of the global POSEIDON study
D Leistner, M Bottcher, G Casu, J F Hojen, B Krakowiak, J Mathisen, L G Mellbin, S Vestergaard Rosenlund, F Roubille, O C Rutherford, N MarxAbstract
Introduction
High-sensitivity C-reactive protein (hsCRP) ≥2 mg/L, is a known risk factor for atherosclerotic CV disease (ASCVD), both with and without concomitant chronic kidney disease (CKD). The POSEIDON study, which included >18,000 individuals globally, was designed to assess the prevalence of high inflammatory risk (hsCRP ≥2 mg/L) among individuals with ASCVD and/or heart failure.
Purpose
To determine the prevalence of high inflammatory risk among individuals with ASCVD enrolled in POSEIDON in Europe and to assess the characteristics of individuals with high inflammatory risk according to the presence of CKD.
Methods
In Europe, POSEIDON enrolled 7456 individuals, including 5194 with ASCVD. Individuals were included as part of routine care visits across 139 sites in nine countries (Czech Republic, Denmark, France, Germany, Italy, Norway, Poland, Sweden, UK) between 2023 and 2025. Individuals with infections, hospitalizations or unplanned visits in the 60 days prior to the routine visit were excluded. The prevalence of high inflammatory risk and the characteristics of individuals with high inflammatory risk were assessed among individuals with ASCVD, either with or without CKD (estimated glomerular filtration rate <60 or ≥60 mL/min/1.73 m2, respectively).
Results
Among the 2300 individuals with ASCVD and CKD, median age was 76 years, 27% were women and 42% had type 2 diabetes. Among the 2894 individuals with ASCVD without CKD, median age was 68 years, 21% were women and 29% had type 2 diabetes. The prevalence of hsCRP ≥2 mg/L was 40.9% in individuals with ASCVD and CKD and 29.6% in those with ASCVD without CKD. In both groups, individuals with hsCRP ≥2 mg/L had a higher body mass index and were more likely to have type 2 diabetes, polyvascular disease or a history of smoking, than individuals with hsCRP <2 mg/L (Table 1). The country-specific prevalence of high inflammatory risk ranged from 25–28% in Nordic countries to 34–45% in Germany (Table 2).
Conclusions
This large, contemporary, cross-sectional study provides insights into the characteristics of individuals with established ASCVD in Europe. High inflammatory risk was present in 4 out of 10 individuals with ASCVD and CKD, and 3 out of 10 individuals with ASCVD alone. Consistent with the global analysis, this sub-analysis of European data identifies multiple characteristics associated with higher inflammatory risk. Collectively, these findings highlight the considerable proportion of patients with ASCVD who may be candidates for emerging therapies that target inflammation.For image description, please refer to the figure legend and surrounding text.For image description, please refer to the figure legend and surrounding text.