Blood Test Helps Identify Women at Risk for Heart Attack
Abrams, who is a professor of medicine at the University of New Mexico and a leader in preventive cardiology, tells WebMD that the study is a "blockbuster." Abrams served on an American Heart Association task force that issued the latest guidelines on risk factors just two months ago, but at that time, this information wasn't published. "At the time, CRP wasn't ready for prime time, but now if it's not ready, it is definitely in the wings. This paper raises the real possibility of altering policy and guidelines. If one recommends [cholesterol] profiles on healthy adults, why not include hs-CRP?"
Another researcher not affiliated with the study, David M. Herrington, MD, MHS, tells WebMD that "the data clearly show that using hs-CRP helps identify people who are at high risk. What we don't know is whether or not these people will favorably respond to one or more forms of treatment." Herrington is associate professor of medicine at Wake Forest University School of Medicine in Winston-Salem, N.C.
William W. O'Neill, MD, director of cardiology at William Beaumont Hospital in Detroit, says the most exciting aspect of this latest report is the very real possibility that hs-CRP may finally help cardiologists identify the "30% to 50% of first heart attack victims who don't fit any of the established risk categories." But, he says, "it is still unknown if lowering [cholesterol] will lower CRP."
Herrington says there may be another use for hs-CRP testing in postmenopausal women. "Estrogen actually makes CRP go up, so if a woman already has elevated CRP it may be useful to advise her to avoid estrogen," says Herrington.
Finally, Abrams says that adding hs-CRP should not have a big economic impact. "I'm told the test only costs $20 or so," he says.
- As many as half of all first-time heart attack victims do not fit into any of the known risk categories, but researchers are finding more evidence that a form of C-reactive protein (CRP) can better predict who will have a heart attack, even in those with no other risk factors.
- CRP is produced in the liver as part of a response to inflammation, and a test for a form of the substance has been recently developed.
- Some researchers believe that patients with high levels of a form of CRP could benefit from taking cholesterol-lowering drugs, called statins, even if their cholesterol levels are normal.