CCL17 as an Inflammatory Biomarker Enhances Cardiovascular Risk Stratification: a Prospective Cohort Study

Inflammation is a key contributor to cardiovascular disease (CVD), yet existing risk models such as Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) and Pooled Cohort Equations (PCE) inadequately identify individuals at intermediate risk. We investigated whether incorporating the inflammatory chemokine CCL17 could improve cardiovascular risk prediction. In two prospective cohorts-the Shunyi Cohort (n = 706, China) and the UK Biobank (n = 36,097, UK)-baseline CCL17 levels were quantified, and major adverse cardiovascular events (MACEs) were tracked over follow-up. Elevated CCL17 levels were independently associated with increased risk of MACEs. Integrating CCL17 into existing models significantly improved discrimination and reclassification, particularly among intermediate-risk individuals (e.g., NRI: 15.1% in Shunyi; 3.0% in UK Biobank). This biomarker-based refinement enabled earlier identification of clinically significant high-risk individuals. These findings suggest that CCL17 is a promising translational biomarker that may enhance precision prevention by augmenting current cardiovascular risk assessment strategies.