Blood Test Could Help Prevent Heart Deaths
Thousands of Deaths Could Be Prevented Each Year by Measuring C-Reactive Protein, Scientists Say
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The Payoff continued...
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.
"There are now over 30 major studies that have shown that CRP levels independently predict heart attack risk," Ridker says. "What has been missing is direct evidence that if you lower CRP you could lower cardiac risk. Now we have two independent papers coming out simultaneously that show this."
The Cleveland Clinic researchers measured arterial plaque buildup along with LDL and CRP levels in 502 patients with heart disease being treated with statin drugs. They found that cholesterol and inflammation levels independently predicted the progression of atherosclerosis.
"The striking thing was that about half the benefit of these drugs came not from lowering cholesterol but from lowering CRP levels," Nissen says. "This means that if a patient has achieved target cholesterol levels on statin therapy but still has elevated CRP, then more aggressive treatment is called for. If you don't work to get CRP levels down you are only getting half the benefits of statin therapy."
The target LDL cholesterol level for very high risk patients on statin drugs was recently lowered from 100 mg/dL to 70 mg/dL.
There are no uniform guidelines for optimal CRP, but Ridker says the goal for heart disease patients should be to lower CRP levels to below 2 mg/L.
American Heart Association spokesperson Sidney Smith Jr., MD, says it is clear from the two studies that some patients could benefit from more aggressive statin treatment. But the optimal treatment strategy for patients who have elevated CRP levels despite aggressive statin treatment is not yet clear, he says.