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Adipokines, Inflammation, and Metabolic Diseases · Journal article
Frontiers in Medicine · August 17, 2026
A consensus or society position rather than new primary data.
This is a perspective article proposing a multimodal implementation framework for assessing and managing residual cardiovascular risk in China by incorporating hs-CRP measurement, lipoprotein(a) testing, and selective low-dose colchicine use in secondary prevention, aligned with recent international guidelines. The framework synthesizes guideline recommendations (2025 ACC Statement, 2026 ACC/AHA) with analysis of barriers to implementation in the Chinese health system and proposes short-, medium-, and long-term priorities to integrate residual-risk assessment into Chinese cardiovascular prevention pathways.
Journal article. Chinese patients with atherosclerotic cardiovascular disease and coronary artery disease; broader applicability to secondary prevention populations in East Asia. China; reference to East Asian data and international guidelines (American College of Cardiology).
2025 American College of Cardiology Scientific Statement highlights hs-CRP as clinically useful inflammatory-risk marker and supports consideration of low-dose colchicine in appropriately selected secondary-prevention patients 2026 ACC/AHA multisociety dyslipidemia guideline provides Class I recommendation for once-in-a-lifetime Lp(a) measurement Emerging East Asian data suggest hs-CRP threshold of approximately 1.0 mg/L may improve inflammatory-risk discrimination in Chinese patients with coronary artery disease
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Clinicians should consider implementing hs-CRP and Lp(a) assessment as components of residual cardiovascular risk stratification in secondary prevention, with recognition that international guideline recommendations may require contextualization to local health systems and patient populations. Low-dose colchicine should be considered only in appropriately selected secondary-prevention patients; elevated Lp(a) alone does not constitute an indication for colchicine.
A perspective piece articulating international guideline recommendations (2025 ACC Statement, 2026 ACC/AHA guideline) and proposing an implementation framework for residual cardiovascular risk assessment in the Chinese population, without new primary trial data.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should consider implementing hs-CRP and Lp(a) assessment as components of residual cardiovascular risk stratification in secondary prevention, with recognition that international guideline recommendations may require contextualization to local health systems and patient populations. Low-dose colchicine should be considered only in appropriately selected secondary-prevention patients; elevated Lp(a) alone does not constitute an indication for colchicine.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Despite achieving guideline-recommended lipid levels, patients with atherosclerotic cardiovascular disease (ASCVD) retain substantial residual risk arising from heterogeneous biological pathways, including persistent inflammation and genetically determined atherogenic susceptibility. High-sensitivity C-reactive protein (hs-CRP) provides a pragmatic measure of potentially modifiable inflammatory activity, whereas lipoprotein(a) [Lp(a)] identifies relatively stable, genetically mediated risk that is not adequately captured by standard lipid panels. The 2025 American College of Cardiology Scientific Statement highlights hs-CRP as a clinically useful inflammatory-risk marker and supports consideration of low-dose colchicine in appropriately selected secondary-prevention patients. The 2026 ACC/AHA multisociety dyslipidemia guideline further provides a Class I recommendation for once-in-a-lifetime Lp(a) measurement, creating a complementary multimodal framework for residual-risk assessment. In China, where cardiovascular disease accounts for a substantial proportion of deaths and the national cardiovascular burden continues to increase, implementation of this framework remains limited. Routine hs-CRP measurement is uncommon, cardiovascular use of colchicine remains negligible, and Lp(a) testing is still concentrated in selected tertiary centers. Emerging East Asian data and a recent Chinese expert advisory suggest that an hs-CRP threshold of approximately 1.0 mg/L may improve inflammatory-risk discrimination in Chinese patients with coronary artery disease; however, this threshold should not yet be interpreted as a stand-alone treatment threshold for colchicine. In this perspective, we compare international recommendations with current Chinese practice, analyze barriers related to infrastructure, safety, education, standardization, and evidence localization, and propose a multimodal implementation framework. Short-term priorities include once-in-a-lifetime Lp(a) measurement, context-specific hs-CRP assessment, intensified management of modifiable atherosclerotic risk factors, and carefully selected use of low-dose colchicine in secondary prevention. Elevated Lp(a) should prompt comprehensive risk-factor intensification and, when appropriate, family-based evaluation, but should not by itself constitute an indication for colchicine. Medium- and long-term priorities include pragmatic trials, real-world registries, assay standardization, cost-effectiveness studies, and policy initiatives to integrate residual-risk assessment into Chinese cardiovascular prevention pathways.
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