Abstract Aims Cardiovascular disease (CVD) remains the leading cause of mortality. New biomarkers are needed to improve CVD risk prediction. Several studies have reported associations between surfactant protein D (SP‐D), an innate immune system component, and CVD; however, general population studies remain scarce. The main aim of this study was to investigate the association between SP‐D and CVD events incidence in the Spanish general adult population. Methods Socio‐demographic, lifestyle (including smoking status) and clinical data from 1707 participants of the di@bet.es cohort without previous CVD events were collected and analysed. CVD events (including both morbidity and mortality) were reported at baseline and after 7.5 years of follow‐up. SP‐D serum levels were measured by ELISA and categorized in quartiles. Results SP‐D categories are associated with CVD events incidence, independently from other strong risk factors such as cardiovascular risk scores (SCORE2 and SCORE2‐OP), BMI, hs‐CRP, or eGFR. Although SP‐D has been linked to smoking, SP‐D categories predicted CVD events incidence even among non‐smokers. The addition of SP‐D to multivariate models improved performance in the assessment, predicting 83% of the events with a specificity of 74% and a sensitivity of 84% in the overall population. Conclusions SP‐D may be considered as a promising biomarker of CVD events in combination with other well established factors in clinical practice.
Oualla‐Bachiri et al. (Sun,) studied this question.