CRP gains notice as key marker of cardiovascular health

Research on C-reactive protein has some experts saying cholesterol guidelines should be rewritten. Others caution it's too soon for routine CRP testing.

By Victoria Stagg Elliott, AMNews staff. Dec. 16, 2002.

Levels of C-reactive protein may be a stronger predictor of potential heart attack or stroke than cholesterol, according to a study published in the Nov. 14 New England Journal of Medicine.

The study, which involved more than 27,000 people, is by far the largest to date. It echoes what experts have suspected and smaller studies have been implying for years: Cholesterol is not the be-all and end-all in predicting cardiovascular health.

About half of people who have heart attacks have normal levels of cholesterol. CRP may be one of the missing links behind cardiovascular events for these people.

"CRP has arrived," said Ishwarlal Jialal, MD, PhD, professor of internal medicine and pathology at the University of California, Davis. "It is time for CRP testing to be used in primary prevention."

Researchers at Harvard Medical School and Brigham and Women's Hospital in Boston, led by Paul M. Ridker, MD, MPH, director of the hospital's Center for Cardiovascular Disease Prevention, analyzed blood samples taken from thousands of participants in the Women's Health Initiative. They also gathered information from autopsy reports, death certificates, medical records and family members about any cardiovascular events.

The investigators found that levels of both cholesterol and C-reactive protein were indicative of potential heart attacks and strokes, although the latter was more so. Also, women with high levels of one didn't necessarily have high levels of the other. [...]