Washington DC, February 24, 2009 - The American Association for Clinical Chemistry devotes the February 2009 issue of its flagship journal Clinical Chemistry to discussing C-Reactive Protein (CRP). Around 50 percent of myocardial infarctions and stroke occur among apparently healthy men and women with low or normal cholesterol levels. The key to this enigma may be CRP which, studies suggest, may be a better predictor of cardiovascular events than LDL (bad) cholesterol. CRP is also covered in the February 2009 issue of Clinical Laboratory News.
WHAT IS C-REACTIVE PROTEIN (CRP)?
CRP is produced by the liver and secreted into the bloodstream. It can be measured with two different tests: the CRP test and the high-sensitivity CRP (hs-CRP) test, each measuring different ranges of CRP levels in the blood. The hs-CRP test can more accurately detect lower concentrations of the protein (it is more sensitive) than the standard CRP test. CRP increases with inflammation and infection as well as following a heart attack, surgery, or trauma. As a result, CRP is one of several proteins that are often referred to as acute phase reactants and is used to monitor changes in inflammation associated with many infectious and autoimmune diseases. It is now believed that inflammation plays a major role in atherosclerosis (the narrowing of blood vessels due to build-up of cholesterol and other lipids), which is often associated with cardiovascular disease (CVD). Studies have shown that measuring CRP with the improved methodology of the highly sensitive assay can identify the risk level for CVD in apparently healthy people. For these high-risk individuals, this more sensitive test allows for measurement of lower concentrations of CRP that may be within the normal range but consistently at the higher end of the range. These normal but relatively high levels of CRP in otherwise healthy individuals have been found to be predictive of the future risk of a heart attack, stroke, sudden cardiac death, and peripheral arterial disease, even when cholesterol levels are within an acceptable range
Ten years ago, cardiologists would not have ordered tests for C-reactive protein for patients with suspected cardiovascular disease. However, the results of the landmark JUPITER (Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin) study, released in November 2008, have confirmed the role of CRP as a biomarker of risk for cardiovascular disease and established it as a means of monitoring the impact of cholesterol-lowering therapy, not only in people with known risks, but also in asymptomatic individuals previously considered at average risk for myocardial infarction, stroke, or death from cardiovascular causes. The study, which made headline news, underscores the importance of inflammation in cardiovascular disease and could result in changes to recommended cardio-protective practices and patient management.
“This is not just a regular clinical trial. It’s a major turning point in preventive cardiology; one of the most significant developments since the inception of the National Cholesterol Education Program,” noted Nader Rifai, PhD, Director of Clinical Chemistry at Children’s Hospital Boston, Professor of Pathology at Harvard Medical School, and Editor-in-Chief of Clinical Chemistry. Rifai has been a leading researcher in evaluating the utility of CRP and its associated assays, and has collaborated extensively with Paul Ridker, MD, principal investigator of the JUPITER study.
For more information about this important development in the prediction of cardiovascular events, interested journalists should contact Peter Patterson at the telephone numbers above.