Graphical Abstract.

Proteomics and lipidomics improve traditional ASCVD risk prediction. Plasma proteomics and lipidomics hold a major promise in improving ASCVD risk prediction offering high-throughput assessment using different techniques. Albeit retrospectively, large proteomic and lipidomic studies have consistently demonstrated improved ASCVD risk prediction in terms of discrimination and reclassification benefit compared to risk scoring with clinical characteristics. Future studies into clinical utility are needed for widespread clinical implementation. ASCVD, atherosclerotic cardiovascular disease; AUC, area under the receiver operating curve; non-HDL-C, non-high-density lipoprotein cholesterol; SCORE2, Systematic COronary Risk Evaluation 2 system; SMART2, Second Manifestations of ARTerial disease 2; LC-MS, liquid chromatography–mass spectrometry; MS, mass spectrometry.