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.