Blood Test Could Help Prevent Heart Deaths
Thousands of Deaths Could Be Prevented Each Year by Measuring C-Reactive Protein, Scientists Say
Jan. 5, 2004 -- Two landmark studies offer the best evidence yet that inflammation plays a key role in heart disease and could immediately change the way doctors monitor and treat patients at risk for heart attacks and strokes.
If the changes are adopted, researchers say that thousands of deaths from heart disease could be prevented in the United States each year.
One key way to prevent heart disease is lowering levels of "bad" LDL cholesterol through diet, exercise, and medication. But these studies suggest that reducing inflammation, which is thought to play a role in heart disease, may be just as important. Doctors can gauge inflammation in the body through a blood test that measures the amount of C-reactive protein (CRP) in the blood.
Study participants taking cholesterol-lowering statin drugs showed reductions in CRP levels. Lowering CRP, like lowering cholesterol, was found to be an important, independent predictor of heart attack and stroke risk. Lowering CRP levels with statin drugs also slowed or reversed atherosclerosis, a buildup of plaque in blood vessel walls also known as hardening of the arteries.
"We now know that it is not just cholesterol that drives the plaque buildup in the arteries. It is also C-reactive protein," Cleveland Clinic cardiovascular researcher Steve Nissen, MD, tells WebMD. Nissen led one of the two studies.
"These days, avant-garde physicians may measure CRP levels once to help determine underlying risk for cardiovascular disease. But that is not enough. CRP is not a risk factor anymore. It is a player. It's a part of the disease process."
Longtime C-reactive protein researcher Paul M. Ridker, MD, led the second study, which was conducted at Harvard University's Brigham and Women's Hospital. Both studies are published in the Jan. 6 issue of The New England Journal of Medicine.
Ridker tells WebMD that while the new findings have important implications for the development of new drugs to prevent heart disease, there is also "an immediate clinical payoff."
"We believe we can save tens of thousands of lives immediately simply by making physicians understand that they need to monitor CRP levels in the same manner that they now monitor cholesterol levels," he says.
The New England Journal of Medicine notes that Ridker is a co-inventor of a CRP blood test, and the patent for the test is held by Brigham and Women's Hospital.
Ridker and colleagues examined the impact on heart disease of lowering LDL cholesterol and CRP levels with statin therapy. The study involved just over 3,700 patients with heart disease.
Lowering CRP levels with statin therapy was found to reduce the risk of heart attack and death from heart disease among patients who did not lower their cholesterol to recommended levels.
Patients with the lowest levels of both LDL cholesterol and CRP after 30 days of statin therapy had the lowest overall risk of heart attack and death from heart disease.